Renal Hemodynamic Changes Assessed by Color Doppler Sonography in Children With Liver Cirrhosis

Abstract

Detection of early renal affection before proceeding to hepatorenal failure as a complication of liver cirrhosis in children will be helpful in the prognosis of the disease. The objective of this study was to detect early hemodynamic changes in children with liver cirrhosis who had normal kidney function tests to measure the pulsatility index (PI) and resistance index (RI) and their correlation to some risk factors (severity of cirrhosis, renal infection, blood hemoglobin level, and the presence of portal hypertension). Thirty children with different stages of liver cirrhosis (with normal kidney function tests) and 10 apparently healthy children were included. RI and PI were measured by Doppler spectral wave analysis for patients and control. Both PI and RI indices were significantly higher in all children with liver cirrhosis compared with the control group. Both indices showed highest values with class C compared with classes B and A. Each was significantly higher in the presence of anemia, renal infection and portal hypertension. Monitoring of resistance indices (PI and RI) measured noninvasively by Doppler sonography is an effective and easy method for detection of very early renal hemodynamic alternation in childhood cirrhosis and consequently early proper management.