Renal Haemodynamics in Patients with Liver Cirrhosis Assessed by Colour Ultrasonography

Wang, Yuchen; Lp, Liu; Wy, Bai; Sb, Wen; Hj, Dan; Yy, Luan; Mx, Zeng; Hu, Baishi

doi:10.1177/147323001103900127

Cited by 18 publications

(9 citation statements)

References 13 publications

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“…Many authors have demonstrated a positive correlation between high pretransplant RI (.0.70), post-transplant morbidity and a poor outcome. 41 In conclusion, high RI ($0.78) is an extremely sensitive and specific parameter for the early identification of high-risk patients of HRS, and DUS is a useful HRS tool.…”

Section: Cirrhosis and Hepatorenal Syndromementioning

confidence: 89%

Resistive intrarenal index: myth or reality?

Granata¹,

Zanoli²,

Clementi³

et al. 2014

BJR

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In renal diagnosis, the B-mode ultrasound is used to provide an accurate study of the renal morphology, whereas the colour and power Doppler are of strategic importance in providing qualitative and quantitative information about the renal vasculature, which can also be obtained through the assessment of the resistive index (RI). To date, this is one of the most sensitive parameters in the study of kidney diseases and allows us to quantify the changes in renal plasma flow. If a proper Doppler ultrasound examination is carried out and a critical analysis of the values obtained is performed, the RI measurement at the interlobar artery level has been suggested in the differential diagnosis between nephropathies. The aim of this review is to highlight the pathological conditions in which the study of intrarenal RI provides useful information about the pathophysiology of renal diseases in both the native and the transplanted kidneys.

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Section: Cirrhosis and Hepatorenal Syndromementioning

confidence: 89%

Resistive intrarenal index: myth or reality?

Granata¹,

Zanoli²,

Clementi³

et al. 2014

BJR

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“…Doppler ultrasound measurement of intrarenal resistance can estimate renal blood flow and correlates with portal pressure [19]. Some studies have shown that intrarenal RIs are significantly increased in cirrhotic patients compared with healthy controls and are even higher in patients with ascites than in patients without ascites [9,10]. Patients with decompensated cirrhosis but normal serum creatinine can already present with elevated RIs [12].…”

Section: Discussionmentioning

confidence: 99%

“…It is routinely used to diagnose transplant rejection or renal artery stenosis [7,8]. Increased intrarenal RIs in patients with liver cirrhosis, especially in the decompensated stage, have been described before as compared to healthy controls [9,10,11,12,13]. Cirrhotic patients with elevated intrarenal RIs tend to develop the HRS, leading to a poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Intrarenal Resistance Index as a Prognostic Parameter in Patients with Liver Cirrhosis Compared with Other Hepatic Scoring Systems

et al. 2012

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Background and Aims: Patients with advanced liver cirrhosis who develop renal dysfunction have a poor prognosis. Elevated intrarenal resistance indices (RIs) due to renal vascular constriction have been described before in cirrhotic patients. In the current study, we prospectively investigated the course of intrarenal RIs and compared their prognostic impact with those of the Model for End-Stage Liver Disease (MELD) and the Child-Pugh scores. Methods: Sixty-three patients with liver cirrhosis underwent a baseline visit which included a sonographic examination and laboratory tests. Forty-four patients were prospectively monitored. The end points were death or survival at the day of the follow-up visit. Results: In 28 patients, a follow-up visit was performed after 22 ± 8 months (group 1). Sixteen patients died during follow-up after 12 ± 8 months (group 2). Group 2 patients showed a significantly higher baseline RI (0.76 ± 0.05) than group 1 patients (RI = 0.72 ± 0.06; p < 0.05). As shown by receiver operating characteristic analysis, the RI and the MELD score achieved similar sensitivity and specificity [area under the curve (AUC): 0.722; 95% confidence interval (95% CI): 0.575–0.873 vs. AUC: 0.724; 95% CI: 0.575–0.873, z = 0.029, n.s.] in predicting survival and were superior to the Child-Pugh score (AUC: 0.677; 96% CI: 0.518–0.837). Conclusion: The RI is not inferior in sensitivity and specificity to the MELD score. Cirrhotic patients with elevated RIs have impaired short- and long-term survival. The RI may help identify high-risk patients that require special therapeutic care.

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“…Renal resistive index (RI) is usually elevated in cirrhotic patients compared to healthy individuals, and is higher in patients with ascites . An increased renal RI correlates with the risk of renal impairment in patients with normal serum creatinine, but does not always correlate with GFR value .…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Beyond serum creatinine: which tools to evaluate renal function in cirrhotic patients?

Carrier

Debette-Gratien

Essig

et al. 2018

Hepatology Research

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In cirrhotic patients, a high serum creatinine value is an independent mortality factor. Similarly, it is predictive of renal insufficiency after liver transplantation. In these cases, chronic kidney disease is also an independent mortality factor. A relevant evaluation of glomerular filtration rate is crucial, particularly in cases of end-stage liver disease or liver transplantation, and is key for the decision to undertake dual liver-kidney transplantation. Serum creatinine or creatinine-based equations are the most used tools in clinical practice but they significantly overestimate renal function. Equilibrium inulin renal clearance remains the gold standard but is time consuming and expensive. Cystatin C and cystatin C-based equations are less influenced by muscle mass or bilirubin value, but their dosage is not standardized and they are expensive. Pharmacological models using exogenous markers, new kidney biomarkers, Doppler coupled with ultrasounds, and kidney histology could be interesting tools but their indications need to be specified.

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Renal Haemodynamics in Patients with Liver Cirrhosis Assessed by Colour Ultrasonography

Cited by 18 publications

References 13 publications

Resistive intrarenal index: myth or reality?

Resistive intrarenal index: myth or reality?

Intrarenal Resistance Index as a Prognostic Parameter in Patients with Liver Cirrhosis Compared with Other Hepatic Scoring Systems

Beyond serum creatinine: which tools to evaluate renal function in cirrhotic patients?

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