Liver cirrhosis is characterized by complex changes of systemic and
splanchanic hnemodynarnics 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
creatinine, and hepatitis virus markers. Radiological investigation: abdominal
ultrasonography and colour duplex imaging ultrasonography.
The present study revealed non-significant changes in resistive index (RI)
and pulsatility index (P1) 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 signcant increase in RI than
in the control group (Pc0.05), 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 signcant 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 patients
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 |
