Functional renal alterations in chronic liver diseases

Area of Science:

• Nephrology
• Hepatology
• Internal Medicine

Background:

• Chronic active hepatitis (CAH) is a serious liver condition.
• Potential kidney involvement in CAH requires further investigation.

Purpose of the Study:

• To investigate kidney function in patients with CAH.
• To compare renal parameters in CAH patients with those suffering from chronic persistent hepatitis (CPH).

Main Methods:

• Studied 83 CAH patients (38 with cirrhosis) and 10 CPH controls.
• Assessed renal plasma flow, glomerular filtration rate, and performed selective renal arteriography and scintigraphy.
• Measured prostaglandin E1 (PGE1) and E2 (PGE2) levels.

Main Results:

• Tubular acidosis was frequently observed in CAH patients.
• CAH patients showed significantly decreased renal plasma flow and glomerular filtration rate compared to CPH.
• Renal arteriography revealed reduced arterial flow in the outer cortex; renal scans indicated tracer escape to the lungs.
• Elevated PGE1 and PGE2 levels were noted in the renal artery versus vein, particularly in cirrhotic CAH patients.

Conclusions:

• Kidney functional impairment is common in early stages of CAH.
• Increased PGE levels and the opening of intrarenal shunts may contribute to kidney dysfunction in CAH.