Plasma Erythropoietin Level In Patients With Liver Cirrhosis And Its Relationship To The Severity Of Cirrhosis And Renal Function

ABSTRACTIntroduction and Aim: Liver cirrhosis and renal impairment are major health problems in Egypt, It had been a long time of controversity surrounding the issue of plasma EPO levels in liver cirrhosis, On the other hand, the interaction between EPO and NO activity which has an implication on the haemodynamic derangement in cirrhotic patients has been rarely discussed. This study was conducted to determine the plasma EPO level in patients with liver cirrhosis as well as in functional renal impairment if it is associated with liver cirrhosis and to correlate between that level and the severity of liver cirrhosis and NO level.Methods: plasma EPO and NO levels were measured in 60 patients with cirrhosis (Child-Pugh class A in 20, Child-Pugh class B and C in 20 and Child-Pugh class B and C with functional renal impairment in 20) and values were compared with those in 10 healthy subjects. Patients with previous history of upper or lower GIT bleeding, hepatic encephalopathy, taking vasoactive drugs within 7 days before the study as well as patients under treatment for HCV or having HCC or lung, endocrinal and bone marrow and organic renal medical diseases were excluded from this study.Results: plasma EPO level was significantly higher in patients with liver cirrhosis compared with healthy controls and during the progression of liver cirrhosis, the plasma EPO level is increased, the highest value was seen in patients with associated functional renal impairment. plasma NO level was significantly increased in patients with liver cirrhosis. However, there was no correlation between plasma EPO level and plasma NO level in our study.Conclusion: Plasma level of EPO in patients with liver cirrhosis is increased than normal levels and is directly related to the severity of cirrhosis and when liver cirrhosis is associated with functional renal impairment, plasma EPO level reaches highest values. Although increased; levels of EPO cannot compensate for the anaemia during the progression of liver cirrhosis which is inversely related to plasma EPO level.Keywords: Erythropoietin, Liver cirrhosis, Renal function, Nitric oxide.