Commonly Observed Laboratory Findings in Hepatic / Liver Failure

 - Elevated conjugated and unconjugated bilirubin - Defects in conjugation and excretion of bilirubin

 - Hypoalbuminemia - Decreased albumin synthesis

 - Elevated ALT and AST - Elevations of —100-fold with acute liver failure; rapid decline to normal can indicate permanent loss of hepatocytes; in chronic liver disease, ALT and AST can be normal

 - Hyperammonemia - Impaired urea cycle

 - Hypoglycemia - Impaired gluconeogenesis in the fasting state after glycogenolysis has exhausted liver glycogen stores

 - Prolonged PT - Decreased production of clotting factors, malabsorption of vitamin K, and decreased clearance of fibrin-split products

 - Thrombocytopenia - As a result of DIC or thrombopoietin deficiency

 - Anemia - Bone marrow suppression leads to chronic anemia; blood loss from

esophageal varices

 - Elevated creatinine and BUN - Decreased urine output; the hepatorenal syndrome may be present; elevated BUN and a normal creatinine can indicate a GI bleed



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