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Renal haemodynamics and function following partial portal decompression.
- Source :
-
HPB . May2009, Vol. 11 Issue 3, p229-234. 6p. - Publication Year :
- 2009
-
Abstract
- Background: This study was undertaken to prospectively evaluate the impact of partial portal decompression on renal haemodynamics and renal function in patients with cirrhosis and portal hypertension. Methods: Fifteen consecutive patients (median age 49 years) with cirrhosis underwent partial portal decompression through portacaval shunting or transjugular intrahepatic portosystemic shunting (TIPS). Cirrhosis was caused by alcohol in 47%, hepatitis C in 13%, both in 33% and autoimmune factors in 7% of patients. Child class was A in 13%, B in 20%and C in 67%of patients. The median score on the Model for End-stage Liver Disease (MELD) was 14.0 (mean 15.0 ± 7.7). Serum creatinine (SrCr) and creatinine clearance (CrCl) were determined pre-shunt, 5 days after shunting and 1 year after shunting. Colour-flow Doppler ultrasound of the renal arteries was also undertaken with calculation of the resistive index (RI) and pulsatility index (PI). Changes in the portal vein--inferior vena cava pressure gradient with shunting were determined. Results: With shunting, the portal vein--inferior vena cava gradients dropped significantly, with significant increases in PI in the early period after shunting. Creatinine clearance improved in the early post-shunt period. However, SrCr levels did not significantly improve. At 1 year after shunting, both CrCl and SrCr levels tended towards pre-shunt levels and the increase in PI did not persist. Discussion: Partial portal decompression improves mild to moderate renal dysfunction in patients with cirrhosis. Early improvements in renal function after shunting begin to disappear by 1 year after shunting. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1365182X
- Volume :
- 11
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- HPB
- Publication Type :
- Academic Journal
- Accession number :
- 91678095
- Full Text :
- https://doi.org/10.1111/j.1477-2574.2009.00040.x