Doppler ultrasonography in the assessment of renal hemodynamics in patients with chronic liver disease

AIM: to assess renal hemodynamics by Doppler analysis of resistive index (R I) in small intrarenal arteries in patients with chronic liver diseases at different stages, and to analyze renal RI in patients with cirrhosis as a f unction of the absence or presence of ascites and the response to diuretic therapy. METHODS: prospective cross-sectional study of 24 patients with chronic hepa titis, 39 with compensated cirrhosis, and 34 with ascites. The last group w as divided into two subgroups: 1) responders to sodium restriction and a lo w dose of diuretics, and 2) patients with refractory ascites or those requi ring high-dose therapy. RESULTS: renal RI was increased in patients with cirrhosis and ascites (0.6 8 +/- 0.06) in comparison with patients with compensated cirrhosis (0.63 +/ - 0.03, p < 0.01). Renal RI in the latter group was higher than in patients without cirrhosis (0.61 +/- 0.04, p < 0.05). Renal RI in patients with asc ites was lower in subgroup 1 than in subgroup 2 (0.65 +/- 0.05 vs 0.72 +/- 0.06, p < 0.01). CONCLUSIONS: renal RI increases as liver disease progresses. Patients with cirrhosis and ascites and increased RI require high-dose treatment or do no t respond. Further studies are needed to demonstrate the predictive value o f renal RI in assessing the effectiveness of diuretic therapy.