DIRECTIONAL ARTERIAL FLOW VELOCITY, SYSTE MIC VASCULAR-RESISTANCE ANDURINARY SODIUM-EXCRETION IN CIRRHOTIC-PATIENTS

Objectives: We have studied the vascular resistance at the posterior t ibial artery utilizing the Doppler reverse/forward now ratio, and its relationship to systemic vascular resistance and renal function in 32 nonazotemic cirrhotic patients. Methods: Patients were divided into th ree groups, Group A comprised 10 patients without ascites or oedema; g roup B comprised 9 patients with ascites and a relatively high sodium excretion (40 +/- 34 mmol/day); and group C comprised 13 patients with ascites and very low sodium excretion (4,9 +/- 2 mmol/day). Results: No significant differences were found in urine flow, creatinine or cre atinine clearance between the three groups, Renin and aldosterone leve ls were found increased in group C, Systemic vascular resistance diffe red significantly in the three groups, being lower in group C, Signifi cant higher values in the Doppler reverse/forward ratio were observed in patients with markedly increased sodium retention and less systemic vascular resistance (group C), The Doppler reverse/forward ratio show ed significant correlations with systemic vascular resistance (r = 0.6 5; n = 32; p < 0.001), urinary sodium excretion (r = 0.53; n = 32; p < 0.01), renin (r = 0.474; n = 32; p < 0.01) and aldosterone levels (r = 0.589; n = 32; p < 0.001). Conclusions: These preliminary results su ggest in patients with hepatic cirrhosis vascular resistance, assessed non-invasively, at the posterior tibial artery, increases with the se verity of sodium retention and the impairment in systemic hemodynamics . Thus, this measurement may be useful for the evaluation and follow-u p of patients with cirrhosis of the liver.