The Value of Renal Artery Resistive Indices: Association with Esophageal Variceal Bleeding in Patients with Alcoholic Cirrhosis

ABSTRACT

PURPOSE: To determine whether resistive indices of the renal artery (RIR) or the splenic artery (RIS) can be used as predictors of bleeding in patients with alcoholic liver cirrhosis. MATERIALS AND METHODS: According to esophageal variceal bleeding episodes, 33 patients with cirrhosis were divided into two groups, a bleeder group (n=17) and a non-bleeder group (n=16). These two groups were compared with respect to five variables (age, spleen size, Child's score, RIS, and RIR). Sensitivity, specificity, and accuracy for the detection of bleeders were calculated using a cutoff value of 0.7 for RIR. RESULTS: The mean values of variables were higher for bleeders than for non-bleeders. With the exception of age, four variables were significantly correlated with bleeding (r=0.43 for spleen size; r=0.36 for Child's score; r=0.37 for RIS; p<0.05, respectively; r=0.63 for RIR, p<0.01). Only RIR was found to be significantly a predictive variable for bleeders (adjusted Odds ratio=19.9; 95% confidence interval 1.3-306, p<0.05) when the RIR was more than 0.7. RIR had a sensitivity of 88.3% and a specificity of 75% with an accuracy of 81.8% at a cutoff value of 0.7 for identifying bleeders. CONCLUSION: A high RIR value will be useful in predicating esophageal variceal bleeding in patients with alcoholic liver cirrhosis.