This document provides an overview of liver and renal function tests, detailing various tests such as total bilirubin, alkaline phosphatase, ALT, AST, total protein, and kidney function tests like blood urea nitrogen and serum creatinine. It explains the normal ranges for these tests and their significance in diagnosing liver and kidney diseases. The document emphasizes the importance of these tests in monitoring health and identifying potential medical conditions.

1. LIVER AND RENAL
FUNCTION TEST
Presented by:- Monnaf Ali
MSc OTAT

2. INTRODUCTION :- LIVER
• The liver is a reddish brown wedge shaped organ with four lobes of unequal size and
shape.
• A human liver normally weighs between 1.2 and1.5 KG.
LIVER FUNCTION TEST
• Liver function tests are blood tests that measure different enzymes, proteins, and other
substances made by the liver.
1. TOTAL BILIRUBIN
2. DIRECT BILIRUBIN
3. ALP
4. SGPT/ALT
5. SGOT/AST
6. TOTAL PROTEIN
7. ALBUMIN
8. GLOBULIN

3. TOTAL BILIRUBIN
• Bilirubin is a yellowish substance made during body’s normal process of
breaking down old Red blood cells.
• When too much bilirubin gets into the
Bloodstream, it can cause jaundice, a condition
That causes Your skin and eyes to turn yellow.
NORMAL RANGE: 0.1 to 1.2 mg/dl (1.71 to 20.5 mol/L )

4. DIRECT BILIRUBIN/CONJUGATED BILIRUBIN
• Direct bilirubin is the form of Bilirubin which has been
Conjugated with glucuronic acid
And is excreted in the bile.
NORMAL RANGE: Less than 0.3 mg/dl
(less than 5.1 mol/L).
INDIRECT BILIRUBIN: TOTAL BILIRUBIN – DIRECT BILIRUBIN

5. ALP(ALKALINE PHOSPHATASE)
• Alkaline phosphatase (ALP) is an enzymes present in many parts of the
body, but it is primarily found in the liver, bones, intestine, and kidneys.
• An ALP blood test can be used for screening, diagnosis, and monitoring of
liver or bone diseases and other health conditions.
NORMAL RANGE : 44 to 174 international units per liter (IU/L)

6. ALT/SGPT
Alanine transaminase/serum glutamate pyruvate
transaminase
• It is an enzymes found mostly in the liver.
• When liver cells are damaged ,they release ALT into the bloodstream.
The alanine aminotransferase (ALT) is a specific marker for liver
inflammation and is typically elevated in individuals with a fatty liver.
NORMAL RANGE : 4 to 36(U/L)

7. AST/SGOT
Aspartate aminotransferase/serum glutamic-oxaloacetic
transaminase
• SGOT is an enzyme that is normally present in liver and heart cells. SGOT
is released into blood when the liver or heart is damaged.
AST levels are high :
1. Chronic hepatitis
2. Damage from alcohol NORMAL RANGE: 4 to 38 U/L
3. Cholestasis, a decrease in bile flow
4. Heart, kidney, bone, or muscle damage
5. Liver cancers
6. Liver scarring, know as liver cirrhosis

8. TOTAL PROTEIN
• A total protein test measures the amount of protein in blood.
• Proteins are important for the health and growth of the body’s cells and
tissues.
• A total protein test can detect normal or abnormal, protein levels, which
can help diagnose medical conditions, such as kidney and liver diseases.
NORMAL RANGE : 6.0 to 8.3 grams per deciliter(g/dl)

9. ALBUMIN
• An albumin blood test checks liver and kidney function.
• Albumin is protein in blood plasma.
• Low albumin levels might be the result of kidney, liver disease,
inflammation or infections. High albumin levels usually the result of
dehydration or severe diarrhea.
NORMAL RANGE : 3.4 to 5.4 g/dl
GLOBULIN= TOTAL PROTEIN - ALBUMIN

10. RENAL FUNCTION TEST
• Kidneys play several vital roles in maintaining your health.one of their most
important jobs is filter waste materials from the blood and expel them from
the body as urine.
• The kidneys also help control the levels of water and various essential
minerals in the body.
• These test are important in identifying the presence of renal disease
monitoring the response of kidneys to treatment and determining the
progression of renal disease.

11. TYPES OF KIDNEY FUNCTION TESTS
• BLOOD TESTS :- Measure the levels of substances in the blood that are
filtered by the kidneys. Such as blood urea nitrogen, serum creatinine.
• URINE TESTS:- Measure the amount of protein, glucose, and other
substances in the urine.
• IMAGING TESTS:- Can be used to get a picture of the kidneys and look for
any problem or damage.
• KIDNEY BIOPSY:- Procedure where a small piece of kidney tissue is removed
and examined under a microscope.

12. BLOOD URINE NITROGEN
• A blood urea nitrogen BUN test is a common blood test that
measure the amount of urea in the blood providing important
information about kidney function.
• Urea nitrogen is a waste product that is produced when the liver
breaks down the proteins and it is filtered out by the kidneys and
eliminated from the body through urine.
• Normal Range :- 7-20 mg/dL

13. SERUM CREATININE TEST
• Measure the level of creatinine in the blood.
• Creatinine is a waste product produced by the muscles.
• Normal Range:-0.7 – 1.3 mg/dL for men
0.6 – 1.1 mg/dL for women
• Elevated serum creatine levels may indicate impaired kidney function this
can be sign of kidney disease or other conditions that affect kidney function
such as dehydration urinary tract obstruction or certain medications on the
other hand lower than normal serum creatinine levels are less common and
may be seen in condition such as decreased muscle mass or liver disease

14. ESTIMATED GLOMERULAR FILTRATION RATE
• Calculates the estimated glomerular filtration rate (eGFR).
• Represented by milliliter per minute (ml/min).
• Normal Range :- 90 ml/min or higher
• Low eGFR result may also indicate chronic kidney disease CKD.
• Higher than normal eGFR levels are less common and may be seen
in people with certain health condition such as pregnancy or
hyperfiltration syndrome.

15. SERUM ALBUMIN TEST
• Measures the amount of albumin in blood.
• Albumin is a protein produced by the liver that helps maintain fluid
balance in the body and carries substances such as hormones,
medicines, and enzymes.
• Normal Range :- 3.5 – 5 g/dL
• Low albumin levels can be a sign of liver or kidney disease or another
medical condition.
• High levels may be sign of dehydration.

16. URINE ANALYSIS
• A key component of kidney function tests and is also known
as urinalysis.
• It involves examining a small sample of urine to check for
signs of kidney disease and other health problem.
• Urine tests can identify early signs of kidney disease such as
the presence of protein in the urine.
• Presence of protein in urine is called proteinuria.

17. THANK YOU