Author/Authors :
Akhavan Rezayat, Kambiz Gastroenterology and Hepatology Research Center - Mashhad University of Medical Sciences - Imam Reza Hospital, Mashhad , Zeraati, Abbas Ali Associate Professor of Nephrology - Kidney Transplantation Complications Research Center - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad , Pezeshki Rad, Masoud Department of Radiology - Imam Reza Hospital - School of Medicine - Mashhad University of Medical Sciences, Mashhad , Chogan, Jalal Gastroenterology and Hepatology Research Center - Mashhad University of Medical Sciences - Imam Reza Hospital, Mashhad , Davoudian, Najmeh Gastroenterology and Hepatology Research Center - Mashhad University of Medical Sciences - Imam Reza Hospital, Mashhad , Akhavan Rezayat, Amir Student Research Committee - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad , Hoseini, Mousalreza Department of Internal Medicine - School of Medicine - Mashhad University of Medical Sciences, Mashhad
Abstract :
BACKGROUND One of the earliest diagnostic signs of hepatorenal syndrome in patients suffering from liver cirrhosis is an increase in the renal vascular resistive index (RI). In this study, the impact of propranolol on decreasing this index and to postpone the probability of hepatorenal syndrome has been investigated. METHODS In the current research, 30 patients with liver cirrhosis with different age and sexes have been enrolled. Demographic data and complete medical history have been collected using a specific questionnaire. At first, renal artery Doppler ultrasonography was performed to determine the RI. The patients were then treated with propranolol, and under supervision, the dose of the drug was increased gradually every 3 to 5 days to reach the target of 25% decrease in resting heart rate. One month after reaching the target dose of the medicine, Doppler ultrasonography was repeated for the patients and the second RI was compared with the pretreatment ones. RESULTS According to our results after treatment with propranolol, a significant decrease of RI was observed (p < 0.01). However, there was no significant difference in the glomerular filtration rate (GFR) before and after treatment with propranolol (p = 0.290). In our study, we found that administering propranolol was associated with significant changes in RI and GFR between the patients with compensated and decompensated cirrhosis (mean change: -0.005 ± 0.017 vs. -0.058 ± 0.045; p < 0.01 for RI and -4.226 ± 17.440 vs. 13.486 ± 12.047; p < 0.01 for GFR in patients with compensated and decompensated cirrhosis, respectively). CONCLUSION Propranolol reduces renal vascular RI in patients with cirrhosis. The response rates in the patients with decompensating cirrhosis were significantly higher than the patients with compensating cirrhosis.
