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. 1998 Dec;43(6):843–848. doi: 10.1136/gut.43.6.843

Effect of meal induced splanchnic arterial vasodilatation on renal arterial haemodynamics in normal subjects and patients with cirrhosis

T Iwao 1, K Oho 1, R Nakano 1, M Yamawaki 1, T Sakai 1, M Sato 1, Y Miyamoto 1, A Toyonaga 1, K Tanikawa 1
PMCID: PMC1727360  PMID: 9824614

Abstract

Aims—To investigate the relation between changes in splanchnic arterial haemodynamics and renal arterial haemodynamics in controls and patients with cirrhosis. 
Methods—Superior mesenteric artery pulsatility index (SMA-PI) and renal artery pulsatility index (R-PI) were measured using Doppler ultrasonography in 24 controls and 36 patients with cirrhosis. These measurements were repeated 30 minutes after ingestion of a liquid meal or placebo. Sixteen controls and 24 patients received the meal, and eight controls and 12 patients received placebo. 
Results—In the fasting condition, patients with cirrhosis had a lower SMA-PI (p<0.01) and a greater R-PI (p<0.01) compared with controls. Placebo ingestion had no effect on splanchnic and renal haemodynamics. In contrast, ingestion of the meal caused a notable reduction in SMA-PI (p<0.01, p<0.01) and an increase in R-PI (p<0.01, p<0.01) in controls and patients with cirrhosis. The meal induced haemodynamic change in SMA-PI was inversely correlated with that in R-PI in controls (t=−0.42, p<0.05) and in patients with cirrhosis (t=−0.29, p<0.05). 
Conclusions—Results support the hypothesis that renal arterial vasoconstriction seen in patients with cirrhosis is one of the kidney's homoeostatic responses to underfilling of the splanchnic arterial circulation. 



Keywords: cirrhosis; Doppler ultrasonography; pulsatility index; renal artery; superior mesenteric artery

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Figure 1 .

Figure 1

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Correlation between the meal induced haemodynamic change in (A) superior mesenteric artery pulsatility index and cardiac index (t=−0.42, p<0.05), and (B) renal artery pulsatility index (t=−0.42, p<0.05) in controls. 


Figure 2 .

Figure 2

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Correlation between the meal induced haemodynamic change in (A) superior mesenteric artery pulsatility index and cardiac index (t=−0.24, p=0.10), and (B) renal artery pulsatility index (t=−0.29, p<0.05) in patients with cirrhosis. 


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