📌 COMPARISON TABLE – KFT vs. LFT
| Parameter | Kidney Function Test (KFT) | Liver Function Test (LFT) |
|---|---|---|
| Main Organs Assessed | Kidneys | Liver |
| Primary Role | Excretion of waste, electrolyte & fluid balance | Metabolism, detoxification, bile production |
| Key Markers | Creatinine, BUN, GFR, Electrolytes | Bilirubin, ALT, AST, ALP, Albumin, INR |
| Disease Indications | CKD, AKI, Nephrotic Syndrome, Glomerulonephritis | Hepatitis, Cirrhosis, Liver Failure, Fatty Liver |
| Common Symptoms | Edema, Hypertension, Oliguria, Metabolic Acidosis | Jaundice, Fatigue, Ascites, RUQ Pain |
📌 HOW TO USE KFT & LFT TOGETHER IN CLINICAL PRACTICE
1️⃣ Assessing Multi-Organ Failure – In sepsis or shock, both kidneys and liver may be affected.
2️⃣ Differentiating Edema Causes – Renal edema (nephrotic syndrome) vs Liver-related edema (cirrhosis, hypoalbuminemia).
3️⃣ Detecting Drug Toxicity – Medications like NSAIDs, antibiotics, or chemotherapy can affect both organs.
4️⃣ Investigating Electrolyte Imbalances – Liver dysfunction can lead to renal complications (hepatorenal syndrome).
5️⃣ Screening for Systemic Disorders – Conditions like autoimmune diseases, infections, and metabolic syndromes affect both liver & kidney.
🔴 CASE 1: CHRONIC LIVER DISEASE (CIRRHOSIS) WITH HEPATORENAL SYNDROME (HRS)
📌 Clinical Presentation:
A 58-year-old male with a history of alcohol use and cirrhosis presents with jaundice, abdominal distension, confusion, and reduced urine output.
🔹 LFT & KFT REPORTS:
| Parameter | Value | Normal Range | Interpretation |
|---|---|---|---|
| Serum Bilirubin (Total) | 7.2 mg/dL | 0.1 – 1.2 mg/dL | Severe jaundice |
| ALT (SGPT) | 58 U/L | 7 – 56 U/L | Mild elevation |
| AST (SGOT) | 98 U/L | 10 – 40 U/L | Alcoholic liver damage |
| Albumin | 2.3 g/dL | 3.5 – 5.5 g/dL | Low → Edema/Ascites |
| INR (Prothrombin Time) | 2.1 | <1.2 | Liver failure → Coagulopathy |
| Creatinine | 2.5 mg/dL | 0.6 – 1.2 mg/dL | Kidney failure (AKI on CKD) |
| BUN | 55 mg/dL | 7 – 20 mg/dL | High |
| GFR | 25 mL/min | >90 mL/min | Chronic kidney damage |
| Sodium (Na⁺) | 125 mEq/L | 135 – 145 mEq/L | Hyponatremia |
🔹 Interpretation:
- LFT shows cirrhosis → High Bilirubin, Low Albumin, High INR
- KFT shows kidney failure → High Creatinine & Low GFR
- Diagnosis: Hepatorenal Syndrome (HRS) → Liver failure leading to kidney dysfunction
🔹 Management:
✅ Albumin infusion + Terlipressin for HRS
✅ Dialysis for worsening kidney function
✅ Liver transplant evaluation
🔵 CASE 2: SEPSIS-INDUCED MULTI-ORGAN FAILURE (LIVER + KIDNEYS)
📌 Clinical Presentation:
A 65-year-old diabetic female with fever, confusion, and low blood pressure due to septic shock (E. coli UTI & bacteremia).
🔹 LFT & KFT REPORTS:
| Parameter | Value | Normal Range | Interpretation |
|---|---|---|---|
| Serum Bilirubin | 5.0 mg/dL | 0.1 – 1.2 mg/dL | Sepsis-induced liver dysfunction |
| ALT (SGPT) | 122 U/L | 7 – 56 U/L | Liver injury (shock liver) |
| AST (SGOT) | 210 U/L | 10 – 40 U/L | High (ischemic hepatitis) |
| INR | 2.3 | <1.2 | Coagulopathy → Sepsis-related DIC |
| Creatinine | 4.0 mg/dL | 0.6 – 1.2 mg/dL | Acute Kidney Injury (Sepsis-induced AKI) |
| BUN | 85 mg/dL | 7 – 20 mg/dL | Severe AKI |
| Lactate | 4.5 mmol/L | <2.0 mmol/L | Septic Shock |
🔹 Interpretation:
- Septic Shock → Multi-organ failure affecting both Liver & Kidneys
- Shock Liver (ischemic hepatitis) → Elevated AST & ALT
- Acute Kidney Injury (AKI) → High Creatinine & BUN due to sepsis
- Coagulopathy (DIC) → High INR → Risk of bleeding
🔹 Management:
✅ IV fluids + Broad-spectrum antibiotics
✅ Vasopressors for BP support
✅ Dialysis for severe AKI
✅ Close monitoring of INR & liver function
🟢 CASE 3: DRUG-INDUCED HEPATOTOXICITY + RENAL IMPAIRMENT (ACETAMINOPHEN TOXICITY)
📌 Clinical Presentation:
A 30-year-old male with a history of overdose on acetaminophen (paracetamol) presents with nausea, RUQ pain, confusion, and oliguria.
🔹 LFT & KFT REPORTS:
| Parameter | Value | Normal Range | Interpretation |
|---|---|---|---|
| Serum Bilirubin | 3.5 mg/dL | 0.1 – 1.2 mg/dL | Liver injury |
| ALT (SGPT) | 870 U/L | 7 – 56 U/L | Massive Hepatocellular Damage |
| AST (SGOT) | 920 U/L | 10 – 40 U/L | Severe Liver Necrosis |
| Creatinine | 3.2 mg/dL | 0.6 – 1.2 mg/dL | Acute Kidney Injury (AKI) |
| BUN | 50 mg/dL | 7 – 20 mg/dL | Acute Renal Dysfunction |
🔹 Interpretation:
- Hepatic failure due to drug-induced hepatotoxicity (Paracetamol OD)
- Acute Kidney Injury secondary to toxin metabolism
- Severe transaminase elevation (ALT & AST > 500) → Drug-induced hepatitis
🔹 Management:
✅ N-Acetylcysteine (NAC) antidote
✅ Supportive care for AKI
✅ Liver transplant evaluation if worsening
📌 WHEN TO ORDER KFT & LFT TOGETHER?
🔹 Suspected Multi-Organ Failure (Sepsis, Shock, Toxin ingestion)
🔹 Severe Edema (Nephrotic vs. Cirrhosis-related)
🔹 Electrolyte Abnormalities with Liver Disease
🔹 Drug Toxicity (NSAIDs, Antibiotics, Acetaminophen, Alcohol)
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