Non-invasive evaluation of renal arterial blood flow in alcoholic cirrhosis of liver

Introduction: Studies of renal perfusion when kidney function tests are still normal could be useful in understanding the pathophysiology of functional kidney impairment in cirrhosis. Kidney functional failure in cirrhosis is considered as a consequence of active renal vasoconstriction. The same have been studied by invasive and non-invasive methods. The present study is aimed at non-invasive assessment of renal artery resistance in patients of cirrhosis of liver. Materials and methods: The present study included 30 cases, patients with different stages of cirrhosis, who were clinically stable, while those with major complications like hepatic encephalopathy, major bleeding etc were excluded. All patients were evaluated clinically and a series of laboratory investigations were done. The resistance in the renal artery was calculates as Resistivity index, by using a color Doppler ultrasonography. Results: In our study, we found the main resistivity index was higher in cases with MELD >20. There was further increase in resistivity index as a severity of the cirrhosis increases. Similarly the MDRD EGFR was decreasing as the severity of cirrhosis was increased. Conclusion: Within limitations of the present study, we conclude that the estimation of the resistivity index in the kidney appears to be a sensitive and easy method for studying the early renal hemodynamic alterations in cirrhotic patients and thus by better understanding the Pathophysiology of hepatorenal syndrome.