2nd PLACE IN THE COMPETITION OF SCIENTIFIC PAPERS IN HEPATOLOGY 2012
The aim: To evaluate the effect of acute administration of dophamine on systemic hemodynamic, renal function and control ascities in patients with cirrhosis. Materials and methods: 51 patients with cirrhosis with normal serum Cr (mean age 54 ± 3,0, males 90,3 %, females 9,7 %) were studied. All patients were measured of urine volume, sodium excretion, glomerular filtration rate (GFR), 24h blood pressure monitoring (BP) before and after dophamine intfavenous introduction (2 - 3 mkg / kg / min during 4 hours). Using receiver operating characteristic curve analysis, a increase of GFR < 5 % was the best value to predict refractor ascities (increase GFR ≥ 10 - 15 % is normal, GFR < 6 - 9 % - is initial sing of interglomerule’s hypertension). Results: 25 patients (48,5 %) had a significant increase a urine volume (p = 0,03), sodium excretion (p = 0,04), GFR (by ≥ 10 %, p = 0,035), mean artery pressure (p = 0,01) after dophamine introduction. This group had a lower risk of developing refractor ascites (p = 0,001). 20 (30,9 %) patients (9 patients - class B Child-Pugh, 8 patients - class C Child-Pugh) had demonstrated a authentic increase a urine volume and mean artery pressure, but low increase GFR (by < 6 - 9 %, p = 0,05). GFR < 5 % was in 6 (11,6 %) patients (2 pts - class B Child-Pugh, 4 pts - class C Child-Pugh) and urine volume did not change, that means high risk of development of a refractory ascites in the given group. Conclusions. The acute hemodynamic response to dophamine can be used to predict current of ascites and the risk of refractory ascites