title: Renal resistive indexes and some renal functions in liver cirrhotic children.
abstract: 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.
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Aydogdu
authors.forename: Ipek
authors.initials: I
authors.lastname: Akil
authors.forename: Talha
authors.initials: T
authors.lastname: Akil
authors.forename: Caner
authors.initials: C
authors.lastname: Kabasakal
authors.forename: Refik
authors.initials: R
authors.lastname: Killi
authors.forename: Sevgi
authors.initials: S
authors.lastname: Mir
authors.forename: Rasit
authors.initials: R
authors.lastname: Yagci
mesh_terms: 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