Liver cirrhosis is characterized by complex changes of systemic and splanchanic haemodynamics. Early vasodilatation occurs mainly in splanchanic area. However with progressive cirrhosis and development of ascites, renal vasoconstriction occurs with increased resistance to renal arterial blood _flow. This work aims to correlate Doppler study of renal arterial resistance with the presence of ascites in patients with decompensated cirrhosis. This study included 30 patients with hepatic cirrhosis and 10 healthy (control). Patients were divided into 3 groups: Group A: 10 cirrhotic patients without ascites. Group B: 10 cirrhotic patients with responsive ascites. Group C: 10 cirrhotic patients with refractory ascites. Patients and controls were subjected to full clinical examination, laboratory investigations including blood picture, liver function tests, serum creatirdne, and hepatitis virus markers. Radiological nvestigation: abdominal ultrasonography and colour duplex imaging ultrasonography. The present study revealed non-significant changes in resistive index (RD and pulsatility index (PD in cirrhotic patients without ascites (Group A) when compared to the control group (P>0.05). However, Cirrhotic patients with responsive ascites (Group B) showed significant increase in RI tha in the control group (P<0.05), and non-significant increase in PI (P> 0.05). Cirrhotic patients with refractory ascites (Group C) showed a highly significant increase in both RI and PI indices compared to the control (P<0.001). There was highly significant positive correlation between severity of ascites, PI and RI. So, Duplex doppler ultrasonography can de- tect early renal increased arterial resistive and pulsatility indices in atients with liver cirrhosis and can be used as early non invasive test for identification of patients with renal arterial vasoconstriction with the risk of developing hepato-renal syndrome |
