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PLASMA COPEPTIN LEVELS ARE INCREASED IN CIRRHOSIS AND CORRELATE WITH HYPONATREMIA AND CIRCULATORY DYSFUNCTION

Journal of Hepatology(2013)

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Abstract
pressure (MAP), heart rate (HR), and portal pressure (PP) were performed 1-35 days afterwards.Hemoglobin (Hb), white blood cell counts (WBC) and platelet counts (PLT) where analyzed from femoral arterial blood.Megakaryocyte-densitiy was evaluated in PAS-staining of sternum specimens and in bone marrow smears.Results: PP was higher in PPVL (16.9 mmHg; p < 0.001) and in BDL (15.3 mmHg; p < 0.001) than in SO animals (8.8 mmHg).Accordingly hyperdynamic circulation was more pronounced in PPVL (MAP: 94 mmHg; p = 0.108, HR: 328bpm; p = 0.131) and in BDL (MAP: 78 mmHg; p = 0.002, HR: 317; p = 0.292) than in SO animals (MAP: 108 mmHg, HR: 303bpm).Hb was significantly lower in PPVL and BDL (13.8±0.7 and 11.4±1.4g/dL) than in SO (14.8±0.7 g/dL; p < 0.001) rats.While WBC and PLT were similar in SO and PPVL animals, BDL rats had significantly higher WBC (19.8±12.9 vs. 4.8±2.0G/L; p < 0.001) and PLT (1471±144 vs. 1120±151 G/L; p < 0.001).Megakaryocytes were regularly distributed throughout the bone marrow and exhibited regular morphology.Splenectomy had no significant effects on hemodynamics or hematological parameters in SO rats, whereas PPVL-SPLECT rats showed lower PP (16.9±2.9 vs. 19.6±3.2 mmHg; p = 0.048) and higher Hb levels (14.4±1.5 vs. 13.8±0.7 g/dL; p = 0.082).Hemodynamic effects of splenectomy were most pronounced in BDL rats, causing a significant PP decrease (14.0±1.3 vs. 15.3±2.1 mmHg; p = 0.010) and MAP increase (91±21 vs. 78±16 mmHg; p = 0.017).Hb increased in BDL-SPLECT animals compared to BDL animals without splenectomy (12.9±0.9 vs. 11.4±1.4g/dL; p = 0.094), as did WBC (26.1±11.1 vs. 19.8±12.9;p = 0.034) and PLT (1710±411 vs. 1471±144 G/L; p = 0.108).Conclusions: Splenectomy decreased portal pressure and ameliorated hyperdynamic circulation, especially in cirrhotic portal hypertensive rats.PPVL and BLD led to a decrease of Hb levels, while when combined with splenectomy, Hb levels remained high.Only BDL rats showed a significant raise of WBC and even PLT, which further increased when splenectomized.
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Key words
plasma copeptin levels,cirrhosis,hyponatremia
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