Efficacy of Nebivolol and Lisinopril in Treatment of Portal Hypertension in Patients with Liver Cirrhosis

Abstract

The development of functional renal failure is a common complication of portal hypertension in patients with decompensated liver cirrhosis (LC). The issues of the formation of functional renal disorders before the development of hepatorenal syndrome (HRS) depending on the degree of portal hypertension have not been sufficiently studied at present. It is known that in 99% of cases, the development of HRS is observed in patients with liver cirrhosis with ascites. The 2-year survival rate in patients with cirrhosis with ascites who respond to diuretic therapy is only 50% [26], and of those resistant to drug therapy, only 50% survive for 6 months. The mechanisms by which portal hypertension affects functional renal disorders and the formation of ascites are not fully understood. Although the threshold of portal pressure required for the development of ascites is not precisely defined, ascites rarely develops in patients with portal pressure below 12 mmHg. In addition, patients with cirrhosis with ascites have higher portal pressure values than patients with cirrhosis without ascites. It is well known that with cirrhosis the main parameters of central hemodynamics change according to the hyperkinetic type, which leads to arterial hypotension, the formation of intraglomerular hypertension with a subsequent decrease in the filtration and excretory functions of the kidneys.