Correlation between Reno-Vascular Resistance Index with Presence and Grading of Esophageal Varicose in Cirrhotic Patients

Bleeding from esophageal varicose (EV) is one of the lethal complications of liver cirrhosis. Upper gastro-intestinal endoscopy (UGIE) is performed in all cirrhotic patients for screening EV but recently some non-invasive methods have been evaluated as a substitute. For this purpose the aim of this study was to assess the correlation between EV and reno-vascular resistance index (RRI) in cirrhotic patients. Subjects and Sixty four cirrhotic patients with normal renal function were included and underwent UGIE ‎and measuring RRI using color flow and pulsed wave Doppler ultrasonography. Correlation between the mean of RRI was evaluated with presence and grade of EV. P<0.05 was considered statistically significant. EV was detected in 42 patients (65.5%). The means of RRI were 0.68±0.03 versus 0.62±0.04 in patients with or without EV, respectively (P<0.001). Moreover, there was a significant statistically difference between the mean of RRI and size of EV (P=0.04). The cutoff points for prediction of EV were: higher than 0.67, had sensitivity, specificity, positive and negative predictive values of 73.8, 72.7, 83.8 and72.8%, respectively. There was a positive association between the Child-Pugh class and presence of EV (P =0.038). In contrast, no correlation between the Child-Pugh class and grade of EV was detected (P =0. 31). These data suggest that the extent of RRI has strong correlation with the presence and degree of EV in cirrhotic patients. Consequently, RRI may be consider as alternative non-invasive marker for screening EV specially in patients with Child-Pugh class A cirrhosis.