Serum glucagon and cystatin C levels with renal doppler sonography findings in non-azotemic liver cirrhosis cases.

ABSTRACT

BACKGROUND/AIMS: It is well known that the hyperdynamic circulatory state in cirrhosis is characterized by increased splanchnic blood flow and renal vasoconstriction. The role of hyperglucagonemia in the renal hemodynamic changes that occur in this patient group is poorly understood at present. This study investigated relationships between serum glucagon levels, indicators of renal function (serum creatinine [Cr] and cystatin C levels, creatinine clearance rate [CrCl]), and renal hemodynamic findings in early and later stages of liver cirrhosis. METHODOLOGY: In total, 40 patients with non-azotemic liver cirrhosis (Group 1) and 20 healthy gender- and age-matched controls (Group 2) were enrolled. The patient group was subdivided into Group la (25 patients with compensated cirrhosis [Child-Pugh A score]) and Group 1b (15 patients with decompensated cirrhosis [Child-Pugh B or C]). RESULTS: Group 1 patients had significantly elevated serum glucagon levels than Group 2 (57.8 +/- 46.7 pmol/L vs. 22.1 +/- 8.1 pmol/L, respectively p<0.05). Group 1b had significantly higher mean serum glucagon than Group la (97.4 +/- 58.8 pmol/L vs. 35.1 +/- 15.2 pmol/L, respectively p<0.05). Although there was no difference between Group la and 1b with respect to mean serum Cr and CrCl, mean serum cystatin C was significantly higher in group 1b than group la (1.6 +/- 0.4 mg/L vs. 1.1 +/- 0.2 mg/L, respectively p<0.05). Group 1 had a significantly higher mean renal resistive index (RRI) than the control group (0.64 +/- 0.1 vs. 0.57 +/- 0.01, respectively, p<0,05). According to Spearman's correlation analysis, serum glucagon was correlated with RRI in Group la (compensated stage of liver cirrhosis) (r=0.52, p=0.008), but not in Group 1b (decompensated stage of cirrhosis) (r=-0.07, p=0.803). RRI was not correlated with serum Cr, Serum Cystatin C, Or Crcl In Either Patient Subgroup. CONCLUSIONS: The findings indicate that hyperglucagonemia may be associated with renal hemodynamic changes in early-stage liver cirrhosis. However, this relationship was not observed in the decompensated stage.