R-Factor (R-Factor)

R-Factor is used for distinguishing acute liver injury (Hepatocellular from Cholestatic). Often used when drug induced liver injury (DILI) is suspected.
Also known as:
R-value
.
Enter values
 
Value
Unit
ALT
ALP

R-Factor ranges

According to Chalasani et al. (2021):
2
5
Risk Scale
Optimal differential diagnosis cutoffs for the R-Factor appear to be:
0
Cholestatic
2
Mixed
5
Hepatocellular
15
  • < 2 - Cholestatic
  • 2 - 5 - Mixed
  • > 5 - Hepatocellular
This isn't medical advice. Consult your healthcare provider.

R-Factor is used for distinguishing acute liver injury (Hepatocellular from Cholestatic). Often used when drug induced liver injury (DILI) is suspected.

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 Mixed

Mixed pattern / inconclusive.

If the presentation is not acute, this pattern is most often seen with fatty liver (NAFLD or alcohol-related).

For Hepatocellular

A hepatocellular pattern is seen in: 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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