Renal resistive indexes and some renal functions in liver cirrhotic children.
BACKGROUND
The aim of the present study was to investigate renal vascular resistive changes in children with different stages of liver cirrhosis without obvious renal failure.


METHODS
Twenty-nine children (14 girls, 15 boys, mean age 11.6 years) with cirrhosis and 20 healthy children (mean age 10.3 years) were investigated for renal vascular resistance with Doppler ultrasonography, urinary sodium, N-acetyl-beta-D glucosaminidase (NAG) and microalbuminuria excretion.


RESULTS
The measurements of renal resistive indexes (RRI) were significantly higher in cirrhotic patients than the control group (0.69 +/- 0.07 vs 0.62 +/- 0.02, P < 0.0001). RRI measurement was found to be increased in decompensated cirrhotic patients than in compensated cirrhotic patients (0.73 +/- 0.05 vs 0.67 +/- 0.08, P < 0.0001). A significant positive relationship was observed between RRI and child score (r = 0.53). Urine NAG/Cr ratio was significantly higher in cirrhotic patients than in the control subjects (P < 0.001). Microalbumin concentrations were increased in the patients with decompensated cirrhosis than in the controls (P = 0.02). Patients with ascites and portal hypertension showed increased RRI values.


CONCLUSIONS
We conclude that patients with cirrhosis are at risk of renal deterioration, which can not be detected by serum urea, creatinine, and glomerular filtration rate. The increase of RRI is associated with the progress of hepatocellular disease, and also the development of ascites and portal hypertension. Elevated urinary sodium excretion, elevated urinary NAG/Cr ratio and microalbuminuria might have a prognostic value especially in patients with Child scores> 6. Hence, monitoring RRI is a non-invasive means of studying early renal hemodynamic alteration in childhood cirrhosis.
Aydogdu
Sema
S
Department of Pediatric Gastroenterology and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey.
Akil
Ipek
I
Akil
Talha
T
Kabasakal
Caner
C
Killi
Refik
R
Mir
Sevgi
S
Yagci
Rasit
R
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D051437:Renal Insufficiency / Q000517:prevention & control*; D018709:Statistics, Nonparametric; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance