Plasma Endothelin Level in Liver Diseases and its Role in Portal Hypertension and Hepatorenal Syndrome
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Endothelin is the most potent endogenous vasoconstrictor yet, identified. It is a 21 aminoacid peptide secreted by the vascular endothelium of many organs like kidneys, lungs, brain and heart. It modulates vasomotor tone, cell proliferation and hormone production. Our study focussed on the possible role of endothelin in the pathogenesis of portal hypertension and in hepatorenal syndrome as well as its role in different liver diseases. This study included 75 Egyptian patients presenting with different liver diseases among whom 31 cases associated with PH and 18 with FIRS. 10 subjects were included as control cases. All subjects were examined clinically and fully investigated to establish their diagnosis. PEC was found to be higher in patients with bleeding oesophageal varices. Also, there was a significant positive correlation between PEC and portal vein diameter. PEC was higher in those patients with HRS compared with cirrhotic patients with normal renal functions, Yet; both had higher levels than normal controls being 10 folds higher in cases with HRS and 3-4 folds higher in cirrhotic patients. It was to be noted that PEC was significantly correlated with renal as well as liver functions tests. It is to be concluded that PEC could be found related to the severity of chronic liver diseases specially in conditions associated with PH as well as FIRS. This may have diagnostic and prognostic values and may be used as a marker for progression of the disease. A contineous studies must be done on the endothelin receptor antagonists which may be beneficial in controlling both portal hypertension and hepatorenal syndrome.