Electron microscopy of liver in patients with chronic haemodialysis

Liver biopsies were performed on 18 haemodialysis patients with clinically as well as clinico-chemically altered liver values and partially positive HBV marker serology, with the view to comparing these values with ultrastructural findings in correlation with histological and immunohistological results. The following characteristic combination of findings was recorded at ultrastructural level: hypertrophy and hyperplasia of agranular endoplasmic reticulum of hepatocytes, haemosiderin deposits in Kupffer cells and hepatocytes, invasion of lymphocytes into Disse and intercellular spaces; megamitochondria in hepatocytes and perisinusoidal fibrosis established in some cases. The same findings proved to be recordable in histological diagnosis of hepatitis or toxico-metabolic liver damage. The study shows that inflammatory lesions are not all the only causes for haemodialysis-related changes in clinico-chemical values, so that liver biopsies together with ultrastructural investigations are indicated for differential diagnosis.