The Differences in Renal Hemodynamics and Plasma Catecholamine Levels between Cirrhotic Patients with and without Ascites

From February 1991 to February 1992, we performed the prospective study to investigate the differences in renal hemodynamics and plasma catecholamine concentrations between cirrhotic patients with ascites and without ascites. Eleven cirrhotic patients without ascites (10 male, 1 female; mean age: 50 ± 11 years old) and 17 cirrhotic patients with ascites (14 male, 3 female; mean age: 52±11 years old) were enrolled for measurement of renal blood flow (RBF), glomerular filtration rate (GFR), plasma concentrations of norepinephrine (NE), and epinephrine (EP). The data were assessed by Student's t-test. Results showed that the cirrhotics with ascites had significantly lower RBF, GFR and higher plasma NE concentration than the ones without ascites (364±142 vs. 465±123 ml/min, p＜0.05; 68.7±26.0 vs. 87.9±18.1 ml/min/1.73m^2, p＜0.05; 146±39 vs. 105±47pg/ml, p＜0.05 respectively), but there was no significant difference in plasma concentration of EP (45.1±16.3 vs. 61.5±38.0 pg/ml, p＞0.05) in the two groups of patients. Considering all cirrhotic patients together (N=28), RBF was significantly correlated with GFR (r=0.6634, p＜0.001), but it was not inversely correlated with the plasma concentration of NE (r=0.0789; p ＞0.05). We concluded that (1) cirrhotic patients with ascites had lower RBF and higher plasma concentration of NE than the ones without ascites, and (2) the decrease of RBF might be a major factor influencing the impairment of GFR in decompensated cirrhotics.