Renal functional disorders in children with liver cirrhosis: role of renal prostaglandins

Renal prostaglandins have been implicated in the pathogenesis of the renal dysfunction of cirrhosis, but the information is fragmentary and often contradictory. To assess the role of renal prostaglandins in renal hemodynamics and sodium handling in cirrhosis, the urinary levels of PGE2 and TXB2 were measured and correlated with the severity of cirrhosis [grade A to C according to Pugh-Child's score] in 40 children, 4 - 14 years of age. From the results obtained it was concluded that, both PGE2 and TXB2 excretion are increased in children with severe cirrhosis [grade B and C]. A larger increase in vasoconstrictor TXB2 than in vasodilator PGE2 is associated with a decrease in GFR. The low FENa in patients with severe cirrhosis in the presence of high PGE2 may be viewed as an sufficient attempt at natriuresis

Atrial natriuretic factor in bilharzial hepatic fibrosis and posthepatitic cirrhosis

Elevated levels of plasma atrial natriuretic factor [ANF] were found in cirrhotic patients. Some investigators reported basal levels, while other reported low levels of ANF. This lead us to investigate the effect of bilaharzial periportal fibrosis [BPD] and bilharzial liver cirrhosis and posthepatic cirrhosis on plasma ANF. 27 patients were selected and divided into three groups. The first group comprized nine patients of bilharzial periportal fibrosis. The second group comprized 9 patients of mixed ANF was measured by radioimmunoassay. Abdominal and cardiac ultrasonography was used for measurement of liver size and echogenicity together with diameter of portal vein, splenic view and cardiac chambers. The results showed that ANF was induced in all group of patient except those developing ascites, they showed levels slightly more than the control group