It is very important to diagnose renal impairment in cirrhosis patients at an early stage before overt HRS develops. In patients with cirrhosis the early renal impairment or renovascular vasoconstriction can be predicted by renal arterial resistance index (RI).
Aims and Objectives: To calculate and compare RI in patients of compensated and decompensated cirrhosis and its prognostic significance.
Materials and Methods: Hundred liver cirrhosis patients were studied in J.A. Group of Hospitals, Gwalior from November 2014 to September 2016. Study cohort was divided into Group A (patients with compensated liver cirrhosis), Group B (patients with decompensated cirrhosis responsive to diuretics), Group C (patients with decompensated cirrhosis resistant to diuretics) and Group D (patients with hepatorenal syndrome). Child Pugh Score was used to classify cirrhosis of liver as Grade A (Total score of 5–6; well compensated disease), Grade B (Total score of 7–9; disease with significant functional compromise) and Grade C (Total score of 10–15; decompensated liver disease).
Results: Most of the patients were male (84%) with mean age of 45.34±13.98 years. In patients with compensated and decompensated cirrhosis mean RI value was 0.56 and0.69 respectively. Out of 3 compensated cirrhosis patients none had RI >0.7 whereas out of 97 decompensated cirrhosis patients 44.33% patients had RI > 0.7 (P >0.05). In Group A, most of the patients had RI <0.60 (n=2; 66.67%), in Group B, most of them had RI range 0.61-0.70 (n=23; 46%), in Group C, most of them had RI range 0.71-0.80 (n=23; 67.64%) and in Group D, most of the patients had RI range >0.80 (n=8; 61.54%) (p<0.05).Out of 27 patients with blood urea ≥ 40, 66.67% patients had RI >0.7 (P<0.05) and out of 24 patients with serum creatinine ≥ 1.5, 70.83% patients were having RI > 0.7 (P< 0.05). Out of 57 patients who had RI <0.7, 2 (3.51%) patients expired whereas out of 43 patients who had RI >0.7, 10 (23.25%) patients expired.
Conclusion: RI increases with degree of hepatic decompensation. Higher value of RI helps in early detection of subsequent kidney dysfunction, and hepatorenal syndrome. Mortality was higher in patients having RI >0.7.