Effect of the severity of liver disease on renal hemodynamics and renal oxygen consumption in patients with cirrhosis]

In patients with cirrhosis, it has been shown that abnormal systemic and splanchnic hemodynamics and systemic oxygen (O2) consumption are related to the severity of liver disease. Little is known on the relationship between the severity of cirrhosis, on one hand, and renal hemodynamics and O2 consumption, on the other. We measured renal hemodynamics and renal O2 consumption in 31 patients Pugh's grade A and B and in 13 patients grade C. Systemic and splanchnic hemodynamics as well as systemic O2 consumption were studied. Renal blood flow, glomerular filtration rate, and renal O2 consumption were not significantly different between grades A and B and grade C patients. The renal fraction of systemic O2 consumption was higher (11.4 +/- 5.9 vs 7.9 +/- 4.1 percent respectively; P less than 0.05) and the systemic O2 consumption (111 +/- 23 vs 128 +/- 26 ml.min-1.m-2 respectively; P less than 0.05) lower in patients with grade C than in grades A and B patients. The degree of systemic hyperkineticism and portal hypertension was related to the severity of cirrhosis. In our patients, renal hemodynamics and renal O2 consumption were not related to the severity of cirrhosis. However, liver failure was associated with an increased renal fraction of systemic O2 consumption due to unchanged renal O2 consumption and decreased systemic O2 consumption.