BRACHIAL AND FEMORAL-ARTERY BLOOD-FLOW IN CIRRHOSIS - RELATIONSHIP TO KIDNEY DYSFUNCTION

Brachial artery and common femoral artery blood flows and cardiac output were measured with duplex-Doppler ultrasonography in 12 normal subjects, 12 patients with compensated cirrhosis and 35 patients with cirrhosis and ascites (8 with functional kidney failure). The aim of this study was to investigate whether arteriolar vasodilation in these vascular territories contributes to hyperdynamic circulation in cirrhosis. Cardiac output was significantly increased and systemic vascular resistance significantly reduced in the three groups of cirrhotic patients. We found no significant differences between normal subjects and compensated cirrhotic patients in brachial artery (55 +/- 7 vs. 57 +/- 7 ml/min) and femoral artery (353 +/- 20 vs. 310 +/- 25 ml/min) blood flow. Nonazotemic cirrhotic patients with ascites showed significantly lower (p < 0.05) brachial artery blood flow (40 +/- 3 ml/min) than healthy subjects and compensated patients. Femoral artery blood flow (327 +/- 25 ml/min), however, was not significantly different. Brachial artery (25 +/- 3 ml/min) and femoral artery (213 +/- 22 ml/min) blood flows were markedly reduced in the patients with kidney failure (p < 0.05 with respect to the other three groups). Glomerular filtration rate correlated directly with brachial (r = 0.74, p = 0.0001) and femoral (r = 0.52, p = 0.03) artery blood flow in the cirrhotic patients. These results indicate that the arteriolar vasodilation causing hyperdynamic circulation in cirrhosis does not take place in the brachial and femoral vascular territories.