The significance of elevated plasma transaminase levels was studied in a group of patients maintained by long-term dialysis. All but one had a nonspecific hepatitis with predominantly lymphocytic infiltration in the portal triads and scattered foci of liver cell necrosis. The histological picture was not that of viral hepatitis and Australia antigen was not found in the serum. We conclude that patients maintained by long-term dialysis develop a nonspecific hepatitis associated with elevated serum glutamic pyruvic transaminase levels, which appears not to be viral in etiology.