Intrarenal resistance index for the assessment of early renal function impairment in patients with liver cirrhosis.

Background: Renovascular vasoconstriction inpatients with hepatorenal syndrome can be quantified by the renal arterial resistance index (RI). We investigated the value of RI measurement in detection of renal function impairment in patients with differ5ent stages of chronic liver disease. Methods: Subjects were divided into 4 groups containing 21 patients with liver cirrhosis and ascites, 25 patients with liver cirrhosis without ascites, 35 patients with fatty liver disease and 78 control subjects. All patients underwent abdominal ultrasound examination with renal RI measurement and correlationwith laboratoy results for renal function. Results: RI was significantly higher in ascitic patients compared to non-ascitic patients (0.74 vs. 0.67, p < 0.01) and in non-ascitic patients withliver cirrhosis than in control subjects (0.67 vs. 0.62, p < 0.01). 48% (19/40) of patients withliver cirrhosis and normal serum creatinine concentration showed elevated RI levefls. There were no significant differencefs in RI levels between patients with fatty liver disease and controls (0.63 vs. 0.62). Conclusions: Intrarenal RI measurements is a predictor of renal vasoconstriction and serves to detect early renal function impairment in cirrhotic patients. The diagnosis of elevated RI may be taken into account in the clinical management of these patients.