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- Title
Increased plasma nitric oxide, L-arginine, and arginase-1 in cirrhotic patients with progressive renal dysfunction.
- Authors
Kayali, Zeid; Herring, Jason; Baron, Pedro; Franco, Edson; Ojogho, Okechukwu; Smith, Jason; Watkins, Gregory; Smith, Douglas; Lamin, Victor; Hoang, Thanh; Sharma, Rajiv; Mathahs, Meleah; Sowers, Lawrance; Brown, Kyle E.; Schmidt, Warren N.
- Abstract
Background and Aims: Increased levels of nitric oxide (NO) are hypothesized to contribute to renal dysfunction in patients with decompensated cirrhosis. In this study, we examined whether splanchnic and/or peripheral NO levels and L-arginine (L-Arg) correlate with progressive renal dysfunction in cirrhotics. Methods: Serum NO metabolites (NOx) and L-Arg were measured in: controls ( n = 10); organ donors ( n = 12); compensated cirrhotics ( n = 17), cirrhotics with ascites ( n = 25), refractory ascites ( n = 11) or hepatorenal syndrome type II (HRS) ( n = 11) and chronic renal failure patients ( n = 18). Results: Plasma NOx and L-Arg levels rose progressively with worsening renal function in decompensated cirrhotics. Both NOx and L-Arg levels were highest in patients with HRS ( P < 0.001 and P < 0.025, respectively). While there were no differences in NOx levels related to the site of sampling, L-Arg levels were lowest in hepatic venous blood. There were significant relationships of NOx and L-Arg with Model for End-Stage Liver Disease score and Child–Pugh scores ( P < 0.04 and P < 0.01, respectively). Multivariate analysis showed a significant relationship between NOx, L-Arg and HRS. Conclusion: Worsening renal function in decompensated cirrhosis is accompanied by progressive elevation in plasma NOx and L-Arg. These findings support the hypothesis that NO-mediated vasodilation is probably linked with the mechanism of progressive renal failure in decompensated cirrhotics.
- Subjects
ARGININE; NITRIC oxide; CIRRHOSIS of the liver; HEPATORENAL syndrome; ASCITES; MULTIVARIATE analysis; VASODILATION; PATIENTS
- Publication
Journal of Gastroenterology & Hepatology, 2009, Vol 24, Issue 6, p1030
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2008.05757.x