CIRCULATING LEVELS OF ENDOTHELIN-1 IN PORTAL HYPERTENSION
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Endothelia is a newly discovered potent vasoconstrictor peptide. Current information concerning endothelin in cirrhosis is conflicting. Plasma endothelin concentration has been found to be increased in some studies, normal or reduced in others. To explain the clinical significance of endothelin in patients with chronic liver diseases, we measured the plasma concentration of endothelin in chronic liver disease patients with portal hypertension either with compensated or decompensated liver and with variant degrees of renal impairment. Thirty patients with portal hypertension were classified into two groups: compensated liver patients (group A) and decompensated liver (Group B). They were further classified into 3 groups: group 1 patients with portal hypertension with normal kidney function. Group 11, portal hypertension patients with renal impairment and group III with portal hypertension with functional renal impairment. Fifteen healthy individuals with matched age and sex served as control group. The plasma endothelin concentration was significantly elevated in patients with cirrhosis with ascites than in normal controls (5.55+1.13 pg/ml vs 4.01±0.68 pg/ml, P <0.01), whereas no significant dfference was observed between the compensated group and normal controls (cirrhosis without ascites 4.14+0.6 pg/ml vs 4.01+0.68, P>0.05). As regards renal function, it was found that endothelin level correlates with the degree of renal impairment (4.7+ 1.1 pg/ml, 5 +1.31 pg/ml and 5.7+ 1.29 pg/ml in groups I, II and III respectively.) From these results elevated circulating plasma levels of endothelin in ascites may play a contributory role in kidney dysfunction in these patients as well as in portal hypertension.