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
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Mustafa Güçlü   

Department of Gastroenterology Yunus Emre Hospital Üsküdar,İstanbul, Turkey
Eur J Gen Med 2011;8(3):182-188
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.
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