Plasma renin concentration represents an independent risk factor for mortality and is associated with liver dysfunction in patients with cirrhosis

2016 Journal of Gastroenterology & Hepatology In press;

BACKGROUND & AIMS: Plasma renin concentration(PRC) is increased in patients with cirrhosis. The aims of this study were to evaluate the relation of PRC to (i) portal hypertension (PHT), (ii) degree of liver dysfunction, (iii) survival. METHODS: PRC (range 2.8-39.9muU/mL) was measured after 30 minutes in supine position. Also Hepatic venous pressure gradient (HVPG), Child-Pugh (CPS), transient-elastography (TE, Fibroscan) and MELD scores were evaluated at this time. Mortality was recorded during follow-up. RESULTS: 150 cirrhotic patients (age:55 +/- 11 years; 73%male; CPS A:41.3%/B:41.3%/C:17.3%) were included. Mean HVPG was 16.6 +/- 6.5 mmHg. Median PRC according to CPS was: A 15.45 muU/mL (95%CI: 1.56-261.5), B 37.3 muU/mL (95%CI: 4.29-1317.65) and C 175.3 muU/mL (95%CI: 5.3-5684;p /= 10 mmHg,n = 123) median PRC was 31.2 muU/mL (95%CI: 2.76-1345.4) in those without 13.7 muU/mL (95%CI: 2.7-428.2; p = 0.009). Significantly higher TE-values (33.2 kPa (13-75) vs 59.65 kPa (14.5-75); p = 0.014) were found in patients with elevated-PRC. Median follow up was 711 days (95%CI: 24-1152). 22/61 (=36.1%) of patients with elevated-PRC and 11/89 (=12.4%) with normal PRC died (p = 0.001). Median PRC was significantly higher in patients that died [83.6 muU/mL (3.39-4451.9) vs 21.5 muU/mL (2.6-1197.9); p = 0.001]. Elevated-PRC (p = 0.005; HR: 3.36 95%CI: 1.46-7.85), HCC (p

Pubmed : 27164413