STUDY OF RENAL RESISTIVITY INDEX IN LIVER CIRRHOSIS IN PREDICTING THE INCIDENCE OF HEPATORENAL SYNDROME

Abstract

In patients with End Stage Liver Disease (ESLD) with ascites,Hepatorenal syndrome (HRS) is a complication with grave prognosis.Doppler evaluation of Renal Resistive Index (RRI) is a simple way of prognostication of patients with high risk of developing HRS.We evaluated 50 consecutive cirrhosis patients with ascites who fulfilled the inclusion criteria and measured RRI index on admission and found that it is a reliable marker of progression to HRS and predicting the renal function at 3 months. Methods: 50 patients of liver cirrhosis from K R Hospital,Mysuru,who met the inclusion criteria were studied from January 2018 to June 2019. Detailed history and physical examination were done. Liver function, renal function test,PT-INR,ultrasound abdomen including RRI was done.Child-Turcotte-Pugh (CTP) score and Model for End stage Liver Disease (MELD) score were calculated. Results: This study included 50 subjects with liver cirrhosis.In our study,5 of the patients (10%) developed HRS during the follow up period of 3 months.3 of them showed increased RRI (>0.7),while 2 of them showed normal RRI (p < 0.002). In those subjects with a normal creatinine during follow up,RRI was elevated in 8 % of the subjects (p < 0.002).Mean RRI in subjects who developed HRS was 0.77 ± 0.11.Mean RRI in patients who did not have HRS was 0.61 ± 0.04. Interpretation and conclusion: In our study, we noted that intrarenal Resistive Index values measured at the time of admission were significantly increased in cirrhotic patients who developed HRS during the 3 months follow up period.