Abstract
BackgroundHepatorenal syndrome is a potentially fatal complication of advanced liver disease. Markers for early diagnosis and identification of high-risk patients are lacking. Our aim was to evaluate the role of renal Duplex ultrasonography in the diagnosis and early prediction of hepatorenal syndrome. This study included 50 patients. Clinical assessment, liver function tests, hepatitis C virus antibody, kidney function tests, and abdominal and renal color Duplex ultrasound were done to all subjects.ResultsUnivariate regression analysis for hepatorenal syndrome showed a statistically significant positive correlation with the Model For End-Stage Liver Disease score (p-value <0.0001) and renal artery hilum resistivity index (p-value = 0.0017). Logistic multivariable regression analysis proved that the renal artery hilum resistivity index was an independent predictor of hepatorenal syndrome. Renal artery hilum resistivity index can be used as a predictor of hepatorenal syndrome with 100% sensitivity and 66.7% specificity with a cut-off value > 0.77.ConclusionThe renal resistive index could be a good predictor of hepatorenal syndrome.
Highlights
Hepatorenal syndrome is a potentially fatal complication of advanced liver disease
Seventeen of them were diagnosed with Hepatorenal syndrome (HRS) based on ICA-acute kidney injury (AKI) criteria
We conclude that Duplex ultrasound of renal arteries is a simple, effective, and non-invasive method which enables the early detection of renal hemodynamic disturbances in patients with liver cirrhosis even before renal dysfunction becomes clinically evident
Summary
Hepatorenal syndrome is a potentially fatal complication of advanced liver disease. Markers for early diagnosis and identification of high-risk patients are lacking. Our aim was to evaluate the role of renal Duplex ultrasonography in the diagnosis and early prediction of hepatorenal syndrome. Liver function tests, hepatitis C virus antibody, kidney function tests, and abdominal and renal color Duplex ultrasound were done to all subjects. Hepatorenal syndrome (HRS) is historically viewed as a functional form of acute kidney injury (AKI) that commonly affects patients with advanced liver disease [1]. Peripheral vasodilatation present in advanced liver disease triggers a myriad of compensatory hormonal and neurohormonal vasoconstrictors which reduce effective renal blood flow [3]. Progression of AKI in this setting is an ominous sign of high mortality risk. Classic renal function tests are inconsistent in providing a measure for actual GFR in hepatic
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