Evaluation of the Difference between Cirrhotic Patients Receiving Propranolol and Those Receiving Propranolol Plus Losartan in terms of Renal Artery Resistive Index

Abstract

Introduction: Portal hypertension is one of the main clinical complications of chronic liver diseases. In only 30% of cirrhotic patients who take propranolol, the hepatic venous pressure reduces to under 12 mm/Hg. The results of studies on the efficiency of losartan (an angiotensin II receptor antagonist) in reducing portal hypertension have been controversial so far. Hepatic venous pressure gradient (HVPG) is measured using an invasive method of catheterization. Studies have shown that the measurement of the renal resistive index (RI) by Doppler ultrasonography has a direct relationship with HVPG. The study population included cirrhotic patients who referred to Ali-ibn-Abi Talbe Clinic, Zahedan, Iran. This clinical trial was conducted based on a self-controlled method. Materials and Methods: In total, 30 cirrhotic patients who met the inclusion criteria were selected for the study. The patients were treated with propranolol 10 mg twice a day for one month, and losartan was then added to their medication regimen. The renal RI of patients was measured before and after losartan administration. Results: The mean of renal RI of patients treated with both propranolol and losartan (0.659±0.58) was higher than that of the patients treated with only propranolol (0.635±0.597) (P=0.005). Conclusion: Our results showed that cirrhotic patients who received propranolol had high renal RI before and after receiving losartan. Accordingly, it seems that losartan had no effects on reducing HVPG hypertension in patients taking propranolol.

Keywords

• doppler ultrasonography
• hepatic venous pressure gradient
• losartan
• portal hypertension
• renal resistive index