Cirrhosis Renal Clinical Trial
Official title:
Description of the Evolution of Plasma and Urinary Concentrations of Iohexol in a Cirrhotic Patient Population: "Pilot Study on 9 Patients"
Background: It is important to accurately assess the glomerular filtration rate (GFR) of
patients with liver diseases, particularly cirrhosis, to deliver care and adjust the drugs'
posology.
Purpose: The frequency of chronic renal failure is underestimated in patients with advanced
liver disease and the difficulty to assess kidney failure justifies the investigator's study,
which aims to describe, by means of a population pharmacokinetic model, the evolution of
plasma and urinary concentrations of iohexol, an effective non-ionic, water-soluble contrast
agent which is used in radiographic procedures, in cirrhotic patients.
Cirrhosis is often complicated by kidney failure and the prognostic value of renal function
(serum creatinine) during cirrhosis is included in the MELD model. In addition, chronic
kidney disease (15%) after liver transplantation is also an independent mortality factor.
The most commonly used methods to estimate GFR are based on creatinine, but in patients
suffering from advanced hepatic disease, such as cirrhosis, this parameter is incorrect, due
to the low creatinine production and potentially to elevated serum bilirubin and decreased
albumin levels. Furthermore, ascites can interfere with serum creatinine concentration. In
this condition, all creatinine-based evaluations of GFR overestimate gold standard-measured
GFR. Specific eGFR equations for liver disease or new approaches for estimating GFR may be
necessary.
The plasma clearance of iohexol is a recognized technique for the measurement of the
glomerular filtration rate (GFR).
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