Caffeine elimination: A test of liver function

Summary Fasting plasma caffeine concentration and various parameters of caffeine elimination from plasma obtained after a standardized oral dose of 140 mg caffeine have been compared in nine patients with liver cirrhosis, eight patients with non-cirrhotic liver disease and ten healthy volunteers with regard to their ability to discriminate between the different groups. Fasting plasma caffeine concentrations were significantly higher in cirrhotics (11.1±10.5 mol/l) than in healthy volunteers (1.5±0.8 mol/l). The respective values measured in patients with non-cirrhotic liver disease (3.1±3.1 mol/l) did not differ significantly from the controls. Plasma disappearance rate and clearance of caffeine were significantly decreased in cirrhotics (0.11±0.02 h^–1; 1.0±0.3 ml/min per kg) and in patients with non-cirrhotic liver disease (0.18±0.04 h^–1; 2.2±0.7 ml/min per kg) as compared to healthy volunteers (0.23±0.04 h^–1; 3.1±0.9 ml/min per kg). Plasma caffeine concentration determined 12 h after administration of the test dosage discriminated best between patients with cirrhosis (5.4±1.6 mol/l), patients with noncirrhotic liver disease (2.0±1.4 mol/l) and healthy volunteers (0.8±0.2 mol/l). These results, the safety of the test compound and the simplicity of a single caffeine determination in plasma 12 h after a standardized dose of caffeine make this test attractive for evaluation of liver function.