Stellenwert der Messung des renalen Widerstandsindex bei Patienten mit Leberzirrhose

Studies of renal perfusion verify that patients with cirrhosis of the liver show renal vasokonstriction already before hepatorenal syndrome occurs. The extent of resistive index detected with doppler ultrasonography corresponds with the risk of developing a hepatorenal syndrome. This study examines in daily routine work if the resistive index is influenced by therapy of blood pressure or diuretics. The study discusses the value of resistive index as a prognostic factor for the development of hepatorenal syndrome. methods: 63 patients with cirrhosis of the liver (child A 17, B 27, C 19) and 31 healthy persons were inquired with dopplersonography. In the group of patients the renal resistive index was compared with resistive index of liver and related with kidney funktion, medical therapy, heart rate, ascites, oesophageal varicose bleeding, kidney failure and TIPS, paracentesis and sclerotherapy. results: The group of patients showed in comparison to the group of healthy persons a significant higher resistive index (p<0,05): healthy persons: 0,61 +/- 0,05, child A: 0,69 +/- 0,06, child B: 0,74 +/- 0,06 and child C: 0,75 +/- 0,05. There was no significant difference in the doppler flowmetry of RI before and after medical treatment [(spironolacton (n = 37), furosemid (n = 29), beta- blocker (n = 12) or lactulose (n = 27)]. Only the reduction of xipamid showed a significant increase of RI (p<0,05). There was a direct correlation between the RI and serumcreatinin (r=0,415). The patients with ascites (57,1%) had a higher RI (in the mean 0,752 +/- 0,053) compared to patients without ascites (0,705 +/- 0,072). Oesophageal varicose and TIPS had no significant influence on RI (0,736 +/- 0,071 vs. 0,734 +/- 0,069 and 0,735+/- 0,071 vs. 0,734 +/- 0,06). In comparison to patients without renal failure patients with renal failure showed a significant higher RI: 0,798 +/- 0,055 vs. 0,723 +/- 0,059 (p<0,05). conclusion: Therapy of blood pressure or hemodynamics at patients with cirrhosis of the liver do not show any significant change of renal perfusion. Further studies are necessary to examine if there is a higher risk for single patients to develope a renal failure. Because of the significant increase of RI in case of patients with renal failure the doppler sonography measurement in clinical routine is a sensible method to recognize patients in the child – classification B or C with a high risk to develope a renal failure. The result can support the indication of specific medical or interventional treatment.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2001

Author dc:creator

• Drewes, Kathrin

Contributors dc:contributor

• Matern, Siegfried

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118955%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A56878