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Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
[Clinical study of renal blood flow and endothelin in cirrhotic patients]
1Department of Gastroenterology, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China.
Insights
This study found that worsening liver function in cirrhosis patients correlates with reduced renal blood flow (RBF). Increased ascites and elevated endothelin (ET) levels also impact RBF, suggesting ET
Area of Science:
- Nephrology
- Hepatology
- Vascular Biology
Context:
- Liver cirrhosis significantly impacts systemic hemodynamics.
- Renal blood flow (RBF) is a critical indicator of kidney function, often affected in liver disease.
- Understanding the interplay between liver dysfunction and renal perfusion is crucial for patient management.
Purpose:
- To investigate the relationship between hepatic dysfunction severity and renal blood flow (RBF) parameters.
- To assess the correlation between ascites, plasma endothelin (ET) levels, and RBF in cirrhosis patients.
- To explore the potential role of endothelin in mediating renal vascular changes associated with liver cirrhosis.
Summary:
- Color-Coded Duplex Ultrasonography revealed that worsening liver function, assessed by the Child's classification, correlated with increased pulsatile index (PI) and resistive index (RI) in interlobar and arcuate arteries.
- Both PI and RI showed a significant increase with the severity of ascites.
- Elevated plasma endothelin (ET) levels were found to be intimately correlated with increased PI and RI, suggesting a role in renal vascular contraction.
Impact:
- Demonstrates a direct correlation between hepatic function and RBF in cirrhosis patients.
- Highlights the association between ascites and altered RBF.
- Provides evidence for endothelin as a potential mediator of renal vasoconstriction in liver cirrhosis, informing potential therapeutic targets.
Objectives:
To find the relationship between hepatic dysfunction and renal blood flow (RBF).
Methods:
49 patients with hepatic cirrhosis were studied via Color-Coded Duplex Ultrasonography detecting the pulsatile index (PI), resistive index (RI), peak systolic velocity (PS), peak diastolic velocity (PD) and peak systolic velocity/peak diastolic velocity (PS/PD) in the interlobar and arcuate arteries. The plasma endothelin (ET) levels were also evaluated.
Results:
According to a modified Child's classification which assesses the severity of liver cirrhosis, we compared different groups and found that the worse the function of liver appeared coincidently with the higher PI and RI, especially RI (0.60+/-0.09, 0.66+/-0.06, 0.72+/-0.07, respectively, P < 0.01); The results also indicated that PI, RI increased obviously followed by the rise of ascites (PI: 1.14+/-0.20, 1.31+/-0.29, 1.42+/-0.36, respectively; RI: 0.61+/-0.09, 0.68+/-0.07, 0.77+/-0.05, respectively). The evaluation of plasma ET level demonstrated that its increment is intimately correlated with PI and RI.
Conclusion:
In patients with cirrhosis, RBF is directly correlated with the hepatic function. The correlation between ascites and RBF is also discovered. In patients who have liver cirrhosis, the plasma ET level obviously increased, indicating that ET probably is one of the active factors of renal vascular contraction.
