URINARY ENDOTHELIN-LIKE IMMUNOREACTIVITY IN PATIENTS WITH CIRRHOSIS

Background/Aims: To investigate a possible relationship between the re nal production of endothelin and the presence of renal dysfunction and activation of vasoactive systems in cirrhosis, the urinary excretion and the circulating plasma levels of immunoreactive endothelin (irET) and the plasma levels of vasoactive hormones were measured in 19 healt hy subjects, 12 cirrhotic patients without ascites and 39 patients wit h ascites and different degrees of renal dysfunction. Methods: The uri nary excretion and the circulating levels of irET were assessed after 5 days on a 40 mEq sodium diet and off diuretics, Renal function param eters and the plasma levels of vasoactive hormones were also measured. Results: Patients with and without ascites had similar values of urin ary irET as compared with healthy subjects (30+/-3, 31+/-3 and 29+/-2 ng/day, respectively, p>0.10). By contrast, patients with ascites had higher circulating levels of irET (15+/-1.2 pg/ml) than patients witho ut ascites and healthy subjects (11+/-1.6 and 5+/-0.4 pg/ml, p<0.01). In patients with cirrhosis, no correlation was found between urinary i rET and circulating irET, Moreover, urinary irET did not correlate wit h liver tests, serum and urine sodium, glomerular filtration rate or v asoactive substances, Patients with hepatorenal syndrome had similar u rinary irET to patients with ascites without hepatorenal syndrome. Con clusions: Urinary excretion of irET is not increased in cirrhotic pati ents with ascites and does not correlate with abnormalities in renal f unction.