title: Diagnostic significance of nitrates and nitrites and L-arginine, in development of hepatorenal syndrome in patients with end stage alcoholic liver cirrhosis.
abstract: Hepatorenal syndrome (HRS) represents a complication of the end-stage liver cirrhosis. The aim of the present study was to analyze concentrations of nitrates and nitrites (NO2 + NO3) and L-arginine in patients with liver cirrhosis and HRS as a possible predictive marker for the development of HRS. The research was performed in a group of 28 patients with cirrhosis and HRS, a group of 22 patients suffering from cirrhosis without HRS and a control group comprised of 42 healthy voluntary blood donors. In patients with end-stage alcoholic liver cirrhosis, with HRS, the concentrations of NO2 + NO3 increased and correlated with the degree of cirrhosis progression, compared to patients without HRS and significantly higher compared to the control group. The level of NO2 + NO3 was in a positive correlation with the degree of liver damage de Ritis coefficient (HRS = 0.72; cirrhosis: = 0.55; control = -0.10). Significant positive correlation was found between NO2 + NO3 concentration and inflammatory marker C-reactive protein (HRSC = 0.75; cirrhosis = 0.70, control = -0.25). The correlation between NO2 + NO3 concentration and creatinine concentration in patients with HRS was significantly higher compared to patients without HRS (HRS = 0.82; cirrhosis = 0.32; control = -0.25). By using binary regression analysis, on the basis of clinical criteria of HRS diagnosis, the strongest independent positive predictor for HRS development was NO2 + NO3, associated with 45.02 times higher incidence of HRS, compared to arginine (12.7 times higher incidence), creatinine (13.1 times higher incidence), and AST/ALT ratio (10.55 higher incidence of HRS). Since the determination of NO2 + NO3 represents a reliable and easily applicable method, it may be used as an early predictive marker for HRS development.
authors: Faculty of Medicine, Pristina-Kosovska Mitrovica, Kosovska Mitrovica, Serbia.
authors: Vanja
authors: V
authors: Nickovic
authors: Gordana
authors: G
authors: Kocic
authors: Goran
authors: G
authors: Bjelakovic
authors: Radmila
authors: R
authors: Pavlovic
authors: Ivana
authors: I
authors: Stojanovic
authors: Radoslav
authors: R
authors: Katanic
authors: Svetlana
authors: S
authors: Stojanovic
authors: Boris
authors: B
authors: Djindjic
mesh_terms: D000328:Adult; D001120:Arginine / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D006530:Hepatorenal Syndrome / Q000097:blood* / Q000209:etiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000097:blood*; D009573:Nitrites / Q000097:blood*
chemical_list: D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; D001120:Arginine