Cavaşi, Eduard; Cavaşi, Adriana; Grigorescu, Mircea
December 2009
Clujul Medical;Dec2009, Vol. 82 Issue 4, p552
Academic Journal
Hepatorenal syndrome (HRS) is the development of a functional, potentially reversible renal failure in patients with advanced and severe liver disease. Early diagnosis and specific therapy of HRS increase the survival chances until transplantation can be performed. The objective of this study was to analyse the value of renal Doppler ultrasonography for detecting early impairment of renal function in patients with liver cirrhosis. The patients were divide into three groups: the group of 35 persons free of liver disease- the control group, the group of 50 patients with liver cirrhosis and normal renal function (from all Child-Pugh categories) and the group of 50 patients with HRS and Child C liver cirrhosis. Patients with other causes of renal failure than HRS were excluded from the study. The interlobar renal arterial impedance indeces were estimated: the pulsatility index (PI) and the resistive index (RI). Both the PI and RI were significantly higher in nonazotemic cirrhotics (PI=1,18±0,19; RI=0,66±0,06) compared to controls (PI=1,02±0,21; RI=0,61±0,05) and were significantly higher in hepatorenal syndrome patients (PI=1,38±0,14; RI=0,75±0,06) compared to nonazotemic cirrhotic patients. The PI and RI were higher in cirrhotic patients with ascites, and the highest value was in HRS cirrhotics. Both indeces showed significant correlation with increased Child-Pugh grade. Conclusion: Renal Doppler ultrasonography could be used for the early identification of a subgroup of patients with liver cirrhosis who are at higher risks for developing hepatorenal syndrome (those with higher impedance indeces: PI>1,3 and RI>0,71).


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