Abstract
Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patient groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r=0.275) and not significant (P>0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload.
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References
Aukland K (1980) Methods for measuring renal blood flow and regional distribution. Annu Rev Physiol 42:543–555
Baldus WP, Feichter RN, Summerskill WH, Hunt JC, Wakim KG (1964) The kidney in cirrhosis. II. Disorders of renal function. Ann Intern Med 60:366–377
Barnardo DE, Baldus WP, Maher FT (1970) Effect of dopamina on renal function in patients with cirrhosis. Gastroenterology 58:524–528
Claude R, Rillegand B, Tournie C, Del Nibbio C (1979) L'insuffisance rénale fonctionelle du cirrhotique. Sem Hop Paris 557:1648–1652
Cohn JN, Tristam FE, Khatri IM (1970) Renal vasodilator therapy in the hepatorenal syndrome. Med Ann D C 39:1–10
D'Addabbo A, Fratello A, Fanfani G, Mele M (1983) Haemodynamic patterns in cirrhosis of the liver: atraumatic quantification of arterial and portal blood flow by radioisotopic angiography. J Nucl Med Allied Sci 27:94 (abstract)
Epstein M, Berk DP, Hollemberg NK, Adams DF, Chalmers TC, Abrams HL, Merrill JP (1970) Renal failure in patients with cirrhosis: the role of active vasoconstriction. Am J Med 49:175–185
Gentilini P, Laffi G, Buzzelli G, Stefani P, Scarpelli P, Paladini S, Smorlesi C, La Villa C, Forti G (1980) Functional renal alteration in chronic liver diseases. Digestion 20:73–78
Gentilini G, Laffi G, Buzzelli G, Smorlesi C, La Villa C, Fantini F (1981) La sindrome epatorenale. L'insufficienza funzionale renale dell'epatico cronico. Policlinico Sez Prat 88:601–607
Kew MC, Brunt PW, Varma RR, Hourigan KJ, Williams HS, Sherloch S (1971) Renal and intrarenal blood flow in cirrhosis of the liver. Lancet 2:504–510
Kinoshita M, Holman BL, Zimmerman RE, Adams DF, Adelstein SJ, Hollemberg NK (1974) Regional intrarenal perfusion in man: an assessment with the scintillation camera. J Nucl Med 15:775–781
Lancestremere RG, Davidson PL, Earley LE, O'Brien FJ, Papper SF (1962) Renal failure in Laenec's cirrhosis. II. Simultaneus determination of cardiac output and renal hemodynamics. J Clin Invest 41:1922–1927
McCloy RM, Baldus WP, Maher FT, Summerskill WHJ (1967) Effects of changing plasma volume, serum albumin concentration, and plasma osmolarity on renal function in cirrhosis. Gastroenterology 53:229–239
Merkel C, Gatta A, Zuin R, Milani L, Spina GP (1980) Renal and intrarenal blood flow in patients with cirrhosis before and after portal-systemic shunt. Scand J Gastroenterol 15:389–394
Merkel C, Gatta A, Milani L, Amodio P, Zuin R (1981) Intrarenal blood flow, circulation time and cortical vascular volume in patients with cirrhosis. Scand J Gastroenterol 16:775–780
Papper S, Belsky JL, Bleifer KH (1959) Renal failure in Laenec's cirrhosis of the liver. First description of clinical and laboratory features. Ann Intern Med 51:759–773
Preston DF, Luke RG (1979) Radionuclide evaluation of renal transplants. J Nucl Med 20:1095–1097
Ring-Larsen H, Merkel C (1981) Le sindromi epato-renali. Policlinico Sez Prat 88:864–872
Ring-Larsen H, Hesse R, Stingsby B (1976) Effect of portalsystemic anastomosis on renal haemodynamics in cirrhosis. Gut 17:856–860
Rosenthall R (1974) Radiotechnetium renography and serial radiohippurate imaging for screening renovascular hypertension. Semin Nucl Med 4:97–116
Rypins EB, Fajman W, Sarper R, Henderson JM, Kutner MH, Tarcan YA, Galambos JT, Warren D (1981) Radionuclide angiography of the liver and the spleen. Noninvasive method for assessing the ratio of portal venous to total hepatic blood flow and portasystemic shunt patency. Am J Surg 142:574–579
Schroeder ET, Shear L, Sancetta SM, Gabuzda GJ (1967) Renal failure in patients with cirrhosis of liver. III. Evaluation of intrarenal blood flow by para-aminohippurate extraction and response to angiotensin. Am J Med 43:887–896
Shaldon S, Silva H, Lawson TR, Walker JG (1963) Measurement of renal red cell and plasma transit times in acute renal failure. Proc Soc Exp Biol Med 12:359–362
Shear L, Kleinermann J, Gabuzda GL (1965) Renal failure in patients with cirrhosis of the liver: first clinical and pathologic characteristics. Am J Med 39:184–198
Stellino E (1982) La sindrome epatorenale. Antolog Med Ital 2:603–609
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Fanfani, G., Fratello, A., Mele, M. et al. Renal perfusion in chronic liver diseases: Evaluation by radiotechnetium renography. Eur J Nucl Med 10, 317–320 (1985). https://doi.org/10.1007/BF00251304
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DOI: https://doi.org/10.1007/BF00251304