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Clinical, hemodynamic and functional particularities of the kidney in liver cirrhosis


Author: Vlasov Lilia
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2012
Scientific adviser: Sergiu Matcovschi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.05-27.03.08
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 16 March, 2012
Approved by NCAA on the 23 May, 2012

Abstract

Adobe PDF document – 0.30 Mb / in romanian

Keywords

liver cirrhosis, hepato-renal syndrome, prostaglandin E-2, endothelin-1, resistance indexe, pulsatility indexe, urinary enzymes.

Summary

It consists from introduction and 6 chapters, conclusions and recomandations, bibliography (195 sources), 6 appendices, 121 pages of main text, 21 figures and 35 tables. The derived results have been published in 16 scientific studies .

Field of study: Internal Medicine.

The purpose and objectives of the study was to evaluate the functional and hemodynamic features of the kidneys, predictive indexex of renal complications in patients with liver cirrhosis.

Novelty and originality consisted in highlighting the clinical, hemodynamic and kidney function in patients with cirrhosis and developed indixes of renal complications and prognosis. Plasma levels of ET-1, PGE-2, urinary enzymes, resistance index, pulsatility index of renal arteries were determined in dependence of Child-Pugh score in patients with hepatic cirrhosis. Scientific problem solved in the study was the description of functional and hemodynamic features of the kidneys in patients with liver cirrhosis and the determination of clinical, laboratory and imagistic predictive indexex of renal complications.

Theoretical significance of the work was to elucidate the clinical features and functional renal hemodynamic impact in liver cirrhosis, including hepato-renal syndrom.

Practical value is in highlighting the clinical, functional and hemodynamic particularities of kidney in liver cirrhosis and to help diagnose early renal complications, allowing the effective therapeutic approach and improve prognosis.

The study results were implemented in clinical practice at nephrology and gastroenterology division of General Hospital “Sfânta Treime” and the ideas and positions of principle are included in courses for students in Medical Clinic nr.1, Department of Internal Medicine from the State Medical and Pharmaceutical University “Nicolae Testemitanu”.