title: Intrarenal resistance index (RI) as a predictor of early renal impairment in patients with liver cirrhosis.
abstract: BACKGROUND
  Despite its functional nature, hepatorenal syndrome (HRS) is associated with a poor prognosis and the only effective treatment is liver transplantation. It is very important to diagnose renal impairment in cirrhosis patients at an early stage before overt HRS develops. In patients with cirrhosis the early renal impairment or renovascular vasoconstriction can be predicted by renal arterial resistance index (RI). Our study aimed to compare RI in healthy controls versus patients with liver cirrhosis with and without ascites and assess its value for predicting subsequent renal status.
  
  
  METHODS
  Patients were divided into 2 groups with 50 patients in each group. Group 1 contained patients with cirrhosis without ascites and group 2 contained cirrhosis patients with ascites. All patients were subjected to detailed clinical examination, laboratory investigations and abdominal doppler ultrasound with renal RI measurements. Patients were followed for 6 months.
  
  
  RESULTS
  RI was significantly higher in cirrhotic patients as compared to healthy controls (0.62 vs. 0.52, p< 0.01). In patients with cirrhosis, RI was significantly greater in patients with ascites than those without ascites (0.70 vs. 0.62, p < 0.01). RI >0.70 was significant independent predictor of subsequent HRS development (p = 0.006) CONCLUSIONS: Intrarenal RI measurement can be used as a predictor of HRS and may be further validated for regular monitoring of cirrhotic patients at risk of developing renal impairment.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Goyal
authors.forename: V K
authors.initials: VK
authors.lastname: Dixit
authors.forename: A K
authors.initials: AK
authors.lastname: Jain
authors.forename: R C
authors.initials: RC
authors.lastname: Shukla
authors.forename: Jayant
authors.initials: J
authors.lastname: Ghosh
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
mesh_terms: D001201:Ascites / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006530:Hepatorenal Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance / Q000502:physiology*