Background/aims: Nitric oxide, a potent vasodilating agent, has been proposed to play a role in pathogenesis of ascites and hepatorenal syndrome. The aim of this study was to evaluate the interaction between the plasma nitric oxide, nitric oxide synthetase levels and renal functions in patients with different degrees of chronic liver disease.
Methods: The study population included 38 subjects: 14 patients with chronic hepatitis, 11 with preascitic cirrhosis and 13 with ascitic cirrhosis. Nitric oxide and nitric oxide synthetase were determined by colorometric assay. We calculated glomerular filtration rate and fractional sodium excretion.
Results: Nitric oxide levels in groups were as follows: 79.28+/-24.86, 99.03+/-21.31, 197.05+/-49.61 microm, respectively. Nitric oxide synthetase levels were 2.64+/-0.56, 3.64+/-0.89, 7.75+/-2.46 micromol/L/sec, respectively. Nitric oxide and nitric oxide synthetase levels in the ascitic cirrhotic group were significantly higher than in the others (p<0.05). When glomerular filtration rates were compared, the only significant difference was determined between the groups with chronic hepatitis and ascitic cirrhosis (92.31+/-25.21, 48.46+/-16.45, p<0.05). Fractional sodium excretion was significantly increased in the ascitic cirrhotic group (4.42+/-2.76, p<0.05).
Conclusions: Nitric oxide and nitric oxide synthetase increased with progression of liver disease, especially in ascitic cirrhosis. We also showed that this increase negatively affects the renal tubular and glomerular functions.