RENAL FUNCTIONS AND RENAL RESISTIVE INDEX (RI) IN CHILDREN WITH CHRONIC LIVER DISEASE
Makaleler > Tam Makale · 1999
Yazarlar: S. Avdoğdu, T. Akil, C. Kabasakal, S. Mir, A. Cura, R. Killi, R V Yağci
Journal of Pediatric Gastroenterology & Nutrition, Uluslararası, Wos, 1999, cilt 28, ss 574-574
DOI: 10.1097/00005176-199905000-00144
Özet
1 In this study 29 children (14 girls, 15 boys, mean age 11.6 yr, range 3-17 yr) with chronic liver disease were investigated for renal function and hemodynamic changes in renal blood flow. Twenty healty children (mean age 10.3 yr) consisted the control group. Renal functions, urinary osmolarity, glomerular filtration rate (GFR), tubular phosphate reabsorption (TPR), urinary N-acetyl glucosaminidase (NAG), α-1 microglobulin, microalbumin levels were detected in all patients. Liver disease was evaluated according to Child-Pugh classification as A, B, C. Secondary renal hemodynamic changes (vasoconstriction) due to liver disease determinated with renal resistive index (RI) by Doppler ultrasonography. Eighteen of children were in stage A and eleven in stage B and C. GFR, TPR, urinary osmolarity and micro albumin were not different from the control group. Moreover ∝-1 microglobulin (produced by liver) and NAG levels were also significantly different from control group even in stage A (p<0.05). There was not any difference between child A and B+C group about NAG and ∝-1 microglobulin levels. Renal RI measurements were found to be increased in both right (p<0.05) and left (p<0.05) kidneys. However, renal RI showed no significant difference between the groups of patients with or without portal hypertension, diagnosed by clinical, endoscopic and sonographic findings. Renal RI measurements were also higher in the patients in stage A than controls (p<0.05) (Table)TableIn conclusion, renal hemodynamic changes and tubulointertitial disorders are present in early stages of chronic liver disease, while GFR, TPR and urinary osmalarity are in normal ranges. This study suggested that urinary NAG and renal RI measurements by Doppler ultrasonography may be useful to detect the early changes of renal function in children with chronic liver disease.