ABSTRACT
Cirrhotic patients exhibit several hemodynamic alterations manifested by tendency to arterial hypotension. Nitric oxide, the potent vasodilator substance, has been postulated to play a major role in these hemodynamic dysfunction. Serum nitrite and nitrate levels with determination of plasma endotoxin and aldosterone levels were evaluated in 40 patients with liver cirrhosis in addition to 10 healthy control subjects. The patients were further classified into 3 groups: Group 1 included 17 pafeitns with compensated cirrhosis, group II: 14 patients with decompensated cirrhosis and ascites and Group III included 9 patients with decompensated cirrhosis, ascites and functional renal failure. Serum nitrite/nitrate and endotoxin levels were significantly increased in cirrhotic patients compared to healthy controls, particularly in decompensated patients. Nitrite/nitrate levels directly correlated with endotoxin levels and aldosterone levels respectively. In conclusion our results suggested that circulating endotoxins in cirrhotics might be responsible for excessive synthesis and release of nitric oxide which may play a key role in hemodynamic dysfunction in cirrhotic patients