Liver and Kidneys Package

EliteMedical's Liver and Kidneys Package detects early dysfunction in the two most metabolically active filter organs — before symptoms develop. The package integrates a targeted internal examination, a blood panel covering liver enzymes (ALT, AST, GGT, bilirubin, albumin), kidney function markers (creatinine, urea, cystatin C, eGFR), and a comprehensive abdominal ultrasound that images the liver, biliary system, and kidneys in real time. Non-alcoholic fatty liver disease (NAFLD) affects an estimated 20–25% of European adults but is often silent until late-stage fibrosis; early detection through enzyme assessment and ultrasound allows dietary and pharmacological intervention before irreversible scarring occurs. Symptoms that may prompt this package include persistent fatigue, nausea, upper abdominal discomfort, dark urine, skin or eye yellowing, or ankle swelling — though many patients with early-stage disease are entirely asymptomatic.

The liver and kidneys together perform over 500 identified biological functions — from drug metabolism and protein synthesis to blood filtration and electrolyte regulation. Early detection of dysfunction in either organ is clinically valuable because both have substantial reserve capacity: significant damage can accumulate before conventional symptoms appear. **Blood panel included:** *Liver markers:* - **ALT (Alanine Aminotransferase)** — released from damaged hepatocytes; the most specific liver injury marker. Elevated in viral hepatitis, NAFLD, alcohol-related liver disease, and drug hepatotoxicity. - **AST (Aspartate Aminotransferase)** — elevated in liver and muscle damage; ALT:AST ratio guides differentiation of causes. - **GGT (Gamma-Glutamyl Transferase)** — sensitive to alcohol use, biliary obstruction, and NAFLD; often the first liver marker to rise. - **Total and direct bilirubin** — products of haemoglobin breakdown processed by the liver. Elevated in liver disease, biliary obstruction, and haemolysis. - **Albumin** — synthesised by the liver; low levels indicate chronic liver insufficiency rather than acute injury. - **Total protein** — global hepatic synthetic function marker. - **Alkaline phosphatase (ALP)** — biliary obstruction and bone marker. *Renal markers:* - **Creatinine** — muscle metabolism waste product cleared by the kidneys; rises as GFR falls. - **eGFR (estimated Glomerular Filtration Rate)** — calculated from creatinine to stage kidney function (CKD stages 1–5). - **Urea (BUN)** — nitrogen waste product from protein metabolism; elevated in renal failure and dehydration. - **Cystatin C** — a more sensitive and less muscle-mass-dependent GFR marker than creatinine; added for patients where creatinine may underestimate renal impairment (e.g., sarcopenic older adults, very muscular individuals). - **Uric acid** — elevated in gout, high-purine diets, and kidney dysfunction. - **Urinalysis** — dipstick and microscopy for protein, glucose, red cells, casts, and infection markers. **Abdominal ultrasound:** - Liver: size, echogenicity (bright liver = fatty liver / steatosis), surface architecture, portal vein diameter, presence of focal lesions (cysts, haemangiomas, suspicious masses) - Biliary system: gallbladder wall thickness, gallstones, common bile duct diameter (biliary obstruction) - Kidneys: size, cortical thickness, corticomedullary differentiation, hydronephrosis, renal stones or masses **The clinical picture:** NAFLD (non-alcoholic fatty liver disease) is now the leading cause of chronic liver disease globally, strongly associated with insulin resistance and metabolic syndrome. It may progress from simple steatosis (reversible with lifestyle change) to NASH (non-alcoholic steatohepatitis) and ultimately cirrhosis over years. A combination of mildly elevated GGT/ALT plus a bright liver on ultrasound constitutes early NAFLD — detectable and reversible at this stage. **When to consider this package:** Persons with obesity, metabolic syndrome, or type 2 diabetes; regular alcohol users wanting a hepatic baseline; patients on long-term medications known to be hepatotoxic (statins, antifungals, some antibiotics); family history of liver disease or polycystic kidney disease; symptoms of urinary tract infection, foamy urine, or ankle oedema.