ORIGINAL ARTICLE
Effects of Autonomic Neuropathy on Renal
Blood Flow in Patients with Liver Cirrhosis
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Başkent University, Faculty of Medicine, Adana Application and Research Hospital, Adana,
Turkey
Publication date: 2011-07-11
Corresponding author
Mustafa Güçlü
Department of Gastroenterology
Yunus Emre Hospital Üsküdar,İstanbul,
Turkey
Eur J Gen Med 2011;8(3):182-188
KEYWORDS
ABSTRACT
Aim: We evaluated the effect of autonomic neuropathy on renal blood
flow in patients with cirrhosis.
Method: Fifty-nine patients with liver cirrhosis and 45 healthy controls
were enrolled in the study. The size and parenchymal thickness
of both kidneys were measured in all patients and controls. Renal vascular
resistance indices(RI) of the kidneys were evaluated by Doppler
ultrasonography and autonomic neuropathy tests defined by Ewing
and Clarke were administered on all patients included in the study.
Result: While there was no difference in parenchymal thickness or
the size of either kidney between cirrhotic patients and the control
group, the renal vascular RI of the renal artery (right kidney 0,70±0,06
vs. 0.61±0.03 and left kidney 0.69±0.06 vs. 0.61±0.03) and interlobar
artery (right kidney 0.65±0.06 vs. 0.57±0.04 and left kidney 0.66±0.06
vs. 0.56±0.03) showed significant difference (p< 0.005). The renal artery
RI of advanced stage cirrhosis (Child-Pugh B and C) was higher
than that of early stage cirrhosis (Child-Pugh A) and the difference
was statistically significant (p= 0.04). The frequency of autonomic
neuropathy increased with Child-Pugh stage (p< 0.05); the comparison
for all parameters (kidney size, parenchymal thickness and RI)
between patients with and without autonomic neuropathy showed no
statistically significant difference between groups (p> 0.05). Similarly,
there was no statistically significant difference in any parameter between
patients with or without ascites (p> 0.05).
Conclusion: Renal artery and interlobar artery RI increased in cirrhotic
patients compared to controls but no effect of autonomic neuropathy
was established on renal hemodynamics.