Background: Liver cirrhosis patients are complicated by different pathological processes leading to increased mortality and morbidity among them. Renal hemodynamic alteration leads to development of hepatorenal syndrome. Renal arterial Doppler study can be an effective screening modality for liver cirrhosis patients. Resistivity and Pusatility indices are parameters measured b renal Doppler which reflects renovascular impedance. There is good correlation between these parameters and severity of liver cirrhosis assessed by Child-Pugh scoring system.

Materials and Methods: This study included 50 cirrhotic patients divided into three groups according to Child-Pugh classification, and fifteen healthy controls. All the patients were subjected to clinical, laboratory and ultrasound evaluation to confirm the diagnosis of cirrhosis. The renal arterial duplex ultrasound examination was conducted on patients as well as controls to measure Pusatility and Resistivity index in main, segmental and cortical renal arteries.

Results: Pusatility and Resistivity index were found to be elevated in the patients of Child class B and C as compared to class A and controls in the main and segmental renal arteries. Both indices were highest in class C than B. The Child class A and controls were not showing statistically significant difference in the main and segmental renal arteries. Resistivity index of the cortical arteries showed significant difference with that of controls. Both Pusatility and Resistivity indices were highest in class C than B and A in cortical arteries. Oesophageal varices also showed significant correlation to elevated Pusatility and Resistivity indices in relation to Child classes.

Conclusion: Both renal Pusatility and Resistive index increase with the degree of the severity of the liver cirrhosis assessed by Child-Pugh classification. Renal duplex ultrasound is a safe, non-invasive and effective screening modality to study the renal hemodynamics and may predict renal dysfunction in different stages of the liver cirrhosis.

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Dr Tejaswi Chalumuri MD (RD)

Department of Radio-Diagnosis, Andhra Medical College, Visakhapatnam, India