R-Factor (R-Factor)
R-Factor ranges
- < 2 - Cholestatic
- 2 - 5 - Mixed
- > 5 - Hepatocellular
R-Factor is used for distinguishing Hepatocellular from Cholestatic liver injury.
R-Factor interpretation
For Cholestatic
Cholestasis is seen in: Gallstones; Malignancy (pancreatic, cholangiocarcinoma); Primary Biliary Cholangitis (PBC); Primary Sclerosing Cholangitis (PSC), often associated with IBD;
Drugs associated with cholestasis: Amoxicillin-clavulanate; macrolides (erythromycin); trimethoprim-sulfamethoxazole; anabolic steroids; combined oral contraceptives; chlorpromazine.
For Hepatocellular
A hepatocellular pattern is seen in: Fatty liver (NAFLD, ALD); Viral Hepatitis or other viral infections; Autoimmune hepatitis; ischemic “shock” liver; Wilson's disease, hemochromatosis, alpha-1 antitrypsin deficiency; Toxin exposure; Budd-Chiari syndrome
Drugs associated with hepatocellular pattern: Acetaminophen (paracetamol); statins; certain antibiotics (e.g., isoniazid, nitrofurantoin); antiepileptics (e.g., valproate, phenytoin); NSAIDs (e.g., diclofenac); methotrexate; amiodarone; herbal/dietary supplements.
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