Hepatitis C diagnosis in patients with chronic kidney disease (CKD) is difficult due to some reasons, such as: presence of nonspecific clinical signs and symptoms, being often asymptomatic; normal or discrete (often fluctuating) levels of the alanine aminotransferase (ALT) enzyme in almost half of the patients with HCV infection; presence of possibly false-negative serology, in addition to the low viremia seen in these patients.23 ALT levels should be checked on admission to the dialysis unit and then monthly. This evidence concerns the gene GPT and chronic kidney disease.