Abstracts
2001 Digestive Disease Week

# 2442 Significant Decrease of Intrarenal Artery Resistance Index in Cirrhotic Patients with Ascites Responsive to Diuretic Therapy
Horst Weiler, Andreas Grandel, Peter Fruehmorgen, Ludwigsburg, Germany

There is no information about the development of the intrarenal arterial resistance indexes (RI), and the endogenous creatinine clearance (ecc) in decompensated nonazotemic cirrhotic patients with ascites before and after recompensation under diuretic therapy (1). The study included 15 healthy controls and 15 decompensated ascitic cirrhotic patients with normal ecc and serum urea levels. We measured RI by duplex Doppler ultrasonography (US) of arcuate arteries in healthy subjects and in ascitic cirrhotic patients before and after recompensation (2). Recompensation after diuretic therapy was defined when no ascites could be proved by US. All patients got furosemide or aldactone or a combination of both diuretics until complete recompensation. Duration of therapy was between 6 and 33 days (mean: 16,7 ± 7,4 d). Serum and urinary electrolytes and creatinine were measured in controls and in all patients before and after recompensation. The RI was significantly higher in cirrhotic patients than in controls and significantly higher in decompensated cirrhotic patients with ascites than in recompensated cirrhotic patients without ascites after diuretic therapy. No correlation was found between a decrease in RI and an alteration in serum creatinine or in ecc. In conclusion, intrarenal vasoconstriction identified by elevated RI can be reversed partially in decompensated nonazotemic cirrhotic patients with ascites responsive to diuretic therapy without deterioration of ecc. 1. Marato A et al. Hapatology 1994;20:839-44 2. Rivolta R et al. Hepatology 1998;28:1235-40

Values of Doppler measurements, endogenous creatinine clearance (ecc) and serum creatinine (s-crea)

cirrhotic patients (n=15) cirrhotic patients (n=15) healthy controls (n=15)

Parameters decompensated with ascites recompensated without ascites

before treatment after treatment

RI 1,05 ± 0,22 ^{a, b} 0,81 ± 0,26 ^{a, c} 0,56 ± 0,09 ^{b, c}

ecc (85-160 ml/min) 102 ± 36 87 ± 43 117 ± 39

s-crea (0,5-1,2 mg/dl) 0,81 ± 0,21 0,89 ± 0,32 0,85 ± 0,14

Data expressed as mean ± SD, significantly different (p<0,05)

^a p<0,01; ^b p<0,0001; ^c p<0,02