Diagnostic Significance of Nitrates and Nitrites and L-Arginine, in Development of Hepatorenal Syndrome in Patients with End Stage Alcoholic Liver Cirrhosis. (June 2013)

• Record Type: Journal Article
• Authors: Nickovic, Vanja; Kocic, Gordana; Bjelakovic, Goran; Pavlovic, Radmila; Stojanovic, Ivana; Katanic, Radoslav; Stojanovic, Svetlana; Djindjic, Boris
• Is Part Of: Renal failure. Volume 35:Number 5(2013)
• Page Start: 633
• Page End: 639
• Publication Date: 2013-06
• Subjects: Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2013.789969
• Languages: English
• ISSNs: 0886-022X

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p>Hepatorenal syndrome (HRS) represents a complication of the end-stage liver cirrhosis. The aim of the present study was to analyze concentrations of nitrates and nitrites (NO<sub>2</sub> + NO<sub>3</sub>) and L-arginine in patients with liver cirrhosis and HRS as a possible predictive marker for the development of HRS. The research was performed in a group of 28 patients with cirrhosis and HRS, a group of 22 patients suffering from cirrhosis without HRS and a control group comprised of 42 healthy voluntary blood donors. In patients with end-stage alcoholic liver cirrhosis, with HRS, the concentrations of NO<sub>2</sub> + NO<sub>3</sub> increased and correlated with the degree of cirrhosis progression, compared to patients without HRS and significantly higher compared to the control group. The level of NO<sub>2</sub> + NO<sub>3</sub> was in a positive correlation with the degree of liver damage de Ritis coefficient (HRS = 0.72; cirrhosis: = 0.55; control = −0.10). Significant positive correlation was found between NO<sub>2</sub> + NO<sub>3</sub> concentration and inflammatory marker C-reactive protein (HRSC = 0.75; cirrhosis = 0.70, control = −0.25). The correlation between NO<sub>2</sub> + NO<sub>3</sub> concentration and creatinine concentration in patients with HRS was significantly higher compared to patients without HRS (HRS = 0.82; cirrhosis = 0.32; control = −0.25). By using binary regression analysis, on the basis of clinical criteria of HRS diagnosis, the strongest independent positive predictor for HRS development was NO<sub>2</sub> + NO<sub>3</sub>, associated with 45.02 times higher incidence of HRS, compared to arginine (12.7 times higher incidence), creatinine (13.1 times higher incidence), and AST/ALT ratio (10.55 higher incidence of HRS). Since the determination of NO<sub>2</sub> + NO<sub>3</sub> represents a reliable and easily applicable method, it may be used as an early predictive marker for HRS development.</p> </abstract>