Cirrhosis

Causes & Risk Factors

Cirrhosis represents the end stage of various chronic liver diseases, most commonly:

•  Chronic viral hepatitis (hepatitis B or C) — major causes of cirrhosis worldwide.

•  MASLD/fatty liver disease — an increasingly common cause of cirrhosis.

•  Alcohol-associated liver disease.

•  Autoimmune liver diseases, including autoimmune hepatitis and primary biliary cholangitis.

•  Other less common causes, including certain inherited metabolic liver conditions.

Symptoms & When to Test

Cirrhosis symptoms often develop gradually and may not appear until the disease is relatively advanced (compensated cirrhosis can be asymptomatic).

•  Fatigue

•  Abdominal swelling (ascites) in more advanced disease

•  Jaundice

•  Easy bruising or bleeding, related to impaired clotting factor production

•  Swelling in the legs

•  Confusion or altered mental status, in advanced disease (hepatic encephalopathy)

•  Often asymptomatic in earlier (compensated) stages

When Should You Consider Testing?

Evaluation is appropriate for known chronic liver disease requiring monitoring, symptoms suggestive of liver dysfunction, or when cirrhosis is suspected based on imaging or other clinical findings.

Why Tests Are Combined

Because liver enzymes alone can be normal or only mildly abnormal even in advanced cirrhosis, a broader panel — CBC (anemia, platelet count), bilirubin, albumin, and PT/INR (synthetic function) — together provides a more complete picture of how well the liver is actually functioning, beyond just detecting ongoing injury.

Creatinine/eGFR and sodium are included because advanced cirrhosis can be associated with kidney dysfunction and fluid/electrolyte abnormalities, which are important both for assessing severity and for guiding management of complications.

Viral hepatitis markers and, where appropriate, AFP for hepatocellular carcinoma surveillance address the underlying cause and a serious potential complication of cirrhosis respectively — identifying a treatable underlying cause and monitoring for cancer risk are both essential parts of comprehensive cirrhosis care.

Tests Available at NPL

Preparation requirements vary by specific test — please follow the instructions provided by your doctor or NPL for the tests ordered.

Home Sample Collection

NPL offers convenient home sample collection for Cirrhosis blood tests, so you don't need to visit a lab in person.

→ Book your test online, via the NPL app, or by calling +977 1 5970147 and select a convenient time slot for home sample collection.

→ A certified and experienced NPL phlebotomist visits your home at the scheduled time, following strict hygiene and safety protocols.

→ Your sample is transported under controlled, monitored conditions to NPL's NABL ACCREDITED UNDER ISO 15189:2022 laboratory for processing.

→ Your digital report is delivered securely to your phone or email, along with access to download and share it as needed.

When to See a Doctor

•  Known chronic liver disease requiring monitoring

•  Unexplained abdominal swelling

•  Jaundice, easy bruising, or leg swelling

•  Confusion or altered mental status with known liver disease — seek prompt evaluation

•  Cirrhosis suspected based on imaging findings