Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites

Roberto Rlvolta, Alessandra Maggi, Massimo Cazzaniga, Daniela Castagnone, Anna Panzeri, Daniela Solenghi, Elettra Lorenzano, Filippo Quarto Di Palo, Francesco Salerno

Research output: Contribution to journalArticle

Abstract

The usefulness in cirrhotic patients of hemodynamic measurements by Doppler ultrasonography (US) is still not defined. We investigated the relationships between Doppler measurements and the severity of ascites. Portal blood flow velocity and volume, and hepatic and renal arterial resistance indexes (RI) were measured in 57 cirrhotic patients (19 without ascites; 28 with responsive ascites, and 10 with refractory ascites) and 15 healthy controls. The renal arterial RI were obtained for the main renal artery, interlobar vessels, and cortical vessels. Cirrhotic patients had decreased portal blood flow and an increased congestion index (CI). Only the CI was correlated to the severity of ascites, showing that it is also a reliable measure of the severity of portal hypertension in patients with ascites. The hepatic and renal artery RI were increased in cirrhotic patients, and the two values were correlated (r = .68; P = .00001). The RI of renal interlobar and cortical vessels were higher in patients with refractory ascites than in patients without ascites (P <.02 and P <.009), and correlated with sodium excretion rate (r = -.45; P <.003), the renin- aldosterone system, and creatinine clearance (r = -.62; P <.0002). The RI decreased from the hilum of the kidney to the outer parenchyma in healthy subjects and patients with responsive ascites, but this difference disappeared in patients with refractory ascites. This indicates that the degree of renal vasoconstriction varies in different areas according to the severity of the ascites. Cortical vessels are involved mainly in patients with refractory ascites, suggesting that the intrarenal blood flow distribution in cirrhosis tends to preserve the cortical area and that severe cortical ischemia is a feature of refractory ascites.

Original languageEnglish
Pages (from-to)1235-1240
Number of pages6
JournalHepatology
Volume28
Issue number5
DOIs
Publication statusPublished - 1998

Fingerprint

Renal Circulation
Ascites
Kidney
Renal Artery
Doppler Ultrasonography
Blood Flow Velocity
Hepatic Artery
Portal Hypertension
Vasoconstriction
Aldosterone
Renin
Creatinine
Healthy Volunteers
Fibrosis
Ischemia
Hemodynamics
Sodium

ASJC Scopus subject areas

  • Hepatology

Cite this

Rlvolta, R., Maggi, A., Cazzaniga, M., Castagnone, D., Panzeri, A., Solenghi, D., ... Salerno, F. (1998). Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. Hepatology, 28(5), 1235-1240. https://doi.org/10.1002/hep.510280510

Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. / Rlvolta, Roberto; Maggi, Alessandra; Cazzaniga, Massimo; Castagnone, Daniela; Panzeri, Anna; Solenghi, Daniela; Lorenzano, Elettra; Quarto Di Palo, Filippo; Salerno, Francesco.

In: Hepatology, Vol. 28, No. 5, 1998, p. 1235-1240.

Research output: Contribution to journalArticle

Rlvolta, R, Maggi, A, Cazzaniga, M, Castagnone, D, Panzeri, A, Solenghi, D, Lorenzano, E, Quarto Di Palo, F & Salerno, F 1998, 'Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites', Hepatology, vol. 28, no. 5, pp. 1235-1240. https://doi.org/10.1002/hep.510280510
Rlvolta R, Maggi A, Cazzaniga M, Castagnone D, Panzeri A, Solenghi D et al. Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. Hepatology. 1998;28(5):1235-1240. https://doi.org/10.1002/hep.510280510
Rlvolta, Roberto ; Maggi, Alessandra ; Cazzaniga, Massimo ; Castagnone, Daniela ; Panzeri, Anna ; Solenghi, Daniela ; Lorenzano, Elettra ; Quarto Di Palo, Filippo ; Salerno, Francesco. / Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. In: Hepatology. 1998 ; Vol. 28, No. 5. pp. 1235-1240.
@article{647be166460e4219964df5438fa36bc4,
title = "Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites",
abstract = "The usefulness in cirrhotic patients of hemodynamic measurements by Doppler ultrasonography (US) is still not defined. We investigated the relationships between Doppler measurements and the severity of ascites. Portal blood flow velocity and volume, and hepatic and renal arterial resistance indexes (RI) were measured in 57 cirrhotic patients (19 without ascites; 28 with responsive ascites, and 10 with refractory ascites) and 15 healthy controls. The renal arterial RI were obtained for the main renal artery, interlobar vessels, and cortical vessels. Cirrhotic patients had decreased portal blood flow and an increased congestion index (CI). Only the CI was correlated to the severity of ascites, showing that it is also a reliable measure of the severity of portal hypertension in patients with ascites. The hepatic and renal artery RI were increased in cirrhotic patients, and the two values were correlated (r = .68; P = .00001). The RI of renal interlobar and cortical vessels were higher in patients with refractory ascites than in patients without ascites (P <.02 and P <.009), and correlated with sodium excretion rate (r = -.45; P <.003), the renin- aldosterone system, and creatinine clearance (r = -.62; P <.0002). The RI decreased from the hilum of the kidney to the outer parenchyma in healthy subjects and patients with responsive ascites, but this difference disappeared in patients with refractory ascites. This indicates that the degree of renal vasoconstriction varies in different areas according to the severity of the ascites. Cortical vessels are involved mainly in patients with refractory ascites, suggesting that the intrarenal blood flow distribution in cirrhosis tends to preserve the cortical area and that severe cortical ischemia is a feature of refractory ascites.",
author = "Roberto Rlvolta and Alessandra Maggi and Massimo Cazzaniga and Daniela Castagnone and Anna Panzeri and Daniela Solenghi and Elettra Lorenzano and {Quarto Di Palo}, Filippo and Francesco Salerno",
year = "1998",
doi = "10.1002/hep.510280510",
language = "English",
volume = "28",
pages = "1235--1240",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites

AU - Rlvolta, Roberto

AU - Maggi, Alessandra

AU - Cazzaniga, Massimo

AU - Castagnone, Daniela

AU - Panzeri, Anna

AU - Solenghi, Daniela

AU - Lorenzano, Elettra

AU - Quarto Di Palo, Filippo

AU - Salerno, Francesco

PY - 1998

Y1 - 1998

N2 - The usefulness in cirrhotic patients of hemodynamic measurements by Doppler ultrasonography (US) is still not defined. We investigated the relationships between Doppler measurements and the severity of ascites. Portal blood flow velocity and volume, and hepatic and renal arterial resistance indexes (RI) were measured in 57 cirrhotic patients (19 without ascites; 28 with responsive ascites, and 10 with refractory ascites) and 15 healthy controls. The renal arterial RI were obtained for the main renal artery, interlobar vessels, and cortical vessels. Cirrhotic patients had decreased portal blood flow and an increased congestion index (CI). Only the CI was correlated to the severity of ascites, showing that it is also a reliable measure of the severity of portal hypertension in patients with ascites. The hepatic and renal artery RI were increased in cirrhotic patients, and the two values were correlated (r = .68; P = .00001). The RI of renal interlobar and cortical vessels were higher in patients with refractory ascites than in patients without ascites (P <.02 and P <.009), and correlated with sodium excretion rate (r = -.45; P <.003), the renin- aldosterone system, and creatinine clearance (r = -.62; P <.0002). The RI decreased from the hilum of the kidney to the outer parenchyma in healthy subjects and patients with responsive ascites, but this difference disappeared in patients with refractory ascites. This indicates that the degree of renal vasoconstriction varies in different areas according to the severity of the ascites. Cortical vessels are involved mainly in patients with refractory ascites, suggesting that the intrarenal blood flow distribution in cirrhosis tends to preserve the cortical area and that severe cortical ischemia is a feature of refractory ascites.

AB - The usefulness in cirrhotic patients of hemodynamic measurements by Doppler ultrasonography (US) is still not defined. We investigated the relationships between Doppler measurements and the severity of ascites. Portal blood flow velocity and volume, and hepatic and renal arterial resistance indexes (RI) were measured in 57 cirrhotic patients (19 without ascites; 28 with responsive ascites, and 10 with refractory ascites) and 15 healthy controls. The renal arterial RI were obtained for the main renal artery, interlobar vessels, and cortical vessels. Cirrhotic patients had decreased portal blood flow and an increased congestion index (CI). Only the CI was correlated to the severity of ascites, showing that it is also a reliable measure of the severity of portal hypertension in patients with ascites. The hepatic and renal artery RI were increased in cirrhotic patients, and the two values were correlated (r = .68; P = .00001). The RI of renal interlobar and cortical vessels were higher in patients with refractory ascites than in patients without ascites (P <.02 and P <.009), and correlated with sodium excretion rate (r = -.45; P <.003), the renin- aldosterone system, and creatinine clearance (r = -.62; P <.0002). The RI decreased from the hilum of the kidney to the outer parenchyma in healthy subjects and patients with responsive ascites, but this difference disappeared in patients with refractory ascites. This indicates that the degree of renal vasoconstriction varies in different areas according to the severity of the ascites. Cortical vessels are involved mainly in patients with refractory ascites, suggesting that the intrarenal blood flow distribution in cirrhosis tends to preserve the cortical area and that severe cortical ischemia is a feature of refractory ascites.

UR - http://www.scopus.com/inward/record.url?scp=0031786045&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031786045&partnerID=8YFLogxK

U2 - 10.1002/hep.510280510

DO - 10.1002/hep.510280510

M3 - Article

C2 - 9794906

AN - SCOPUS:0031786045

VL - 28

SP - 1235

EP - 1240

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 5

ER -