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Increased urinary endothelin excretion in patients with liver cirrhosis
M Kitano1, J Uemasu, H Kawasaki
1Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Insights
Patients with liver cirrhosis show higher urinary endothelin levels, linked to kidney function. This suggests elevated plasma endothelin, not kidney production, drives increased urinary endothelin in cirrhosis.
Area of Science:
- Nephrology
- Hepatology
- Endocrinology
Background:
- Chronic liver disease, particularly liver cirrhosis, is associated with significant renal complications.
- Endothelin, a potent vasoconstrictor peptide, is implicated in cardiovascular and renal pathophysiology.
- Understanding the role of endothelin in renal dysfunction in liver cirrhosis is crucial for patient management.
Purpose of the Study:
- To investigate urinary endothelin levels in patients with chronic liver disease.
- To explore the relationship between endothelin and renal function markers in liver cirrhosis.
- To determine the source of increased urinary endothelin in cirrhotic patients.
Main Methods:
- Measurement of plasma and urinary endothelin levels.
- Assessment of renal function parameters including creatinine clearance and urinary sodium excretion.
- Correlation analysis between endothelin levels, renal function, and urinary kallikrein.
Main Results:
- Plasma and urinary endothelin levels were significantly elevated in liver cirrhosis (LC) patients compared to chronic hepatitis (CH) and controls (C).
- Urinary endothelin showed a positive correlation with creatinine clearance and a negative correlation with urinary kallikrein in LC.
- Urinary sodium excretion correlated with plasma endothelin but not urinary endothelin in LC.
Conclusions:
- Increased urinary endothelin excretion in liver cirrhosis is primarily due to elevated plasma endothelin levels, not increased renal production.
- A potential interaction between the endothelin system and the kallikrein-kinin system exists in liver cirrhosis.
- These findings highlight endothelin's role in renal alterations associated with liver cirrhosis.
Abstract:
The urinary endothelin level in patients with chronic liver disease was determined in order to explore its possible involvement in renal function. The plasma endothelin level was significantly higher in patients with liver cirrhosis (LC) than in those with chronic hepatitis (CH) or in control patients (C). Similarly, urinary endothelin excretion in LC was significantly increased, compared with CH and C. Urinary endothelin demonstrated a significant positive correlation with creatinine clearance. The ratio of endothelin clearance/creatinine clearance did not differ statistically among the three groups. Urinary sodium excretion in LC was positively correlated with plasma endothelin, but not with urinary endothelin. Urinary endothelin excretion demonstrated a significant negative correlation with urinary kallikrein in LC. The present data suggest that increased urinary endothelin excretion in cirrhotic patients primarily depends upon elevated plasma levels of endothelin, but not renal production. Also, a possible link between endothelin and the kallikrein-kinin system in liver cirrhosis is indicated.