Which lab value indicates a worsening condition in a patient with liver dysfunction?

An elevated alkaline phosphatase level indicates a worsening condition in a patient with liver dysfunction because it often reflects cholestasis or biliary obstruction, which can occur in various liver diseases. When the liver or bile ducts are damaged or obstructed, alkaline phosphatase is released into the bloodstream, resulting in increased levels. This condition requires further evaluation and intervention, as it suggests ongoing liver injury or dysfunction.

Normal ALT levels wouldn't indicate worsening liver dysfunction since ALT is usually elevated in liver cell injury. Decreased serum bilirubin suggests improved liver function or a less severe condition, while stable serum ammonia levels do not indicate deterioration because they would reflect stable liver function regarding the liver's ability to remove ammonia from the bloodstream. Together, these factors illustrate why elevated alkaline phosphatase is a crucial marker of worsening liver condition.