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Hepatic drug clearance in chronic liver disease: Can we expect to find a universal, quantitative marker of hepatic function?
Author(s) -
Morgan Denis J.,
Smallwood Richard A.
Publication year - 1989
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840100525
Subject(s) - indocyanine green , cirrhosis , chronic liver disease , hepatic function , medicine , blood flow , liver function , endocrinology , liver disease , liver function tests , chemistry , gastroenterology , pathology
Blood clearance of antipyrine, indocyanine green, and galactose were measured to evaluate the alterations of effective hepatic blood flow and hepatic intrinsic clearances in chronic liver diseases. Galactose blood clearance, which may be taken as effective hepatic blood flow, decreased by approximately 30% in patients with cirrhosis (12.49 ± 0.76 ml/min/kg; mean ± SE; n = 17) compared with normal subjects (18.17 ± 1.03 ml/min/kg; n = 5). In patients with cirrhosis, intrinsic clearances of antipyrine (9.178 ± 0.14 ml/min/kg; n = 17) and indocyanine green (6.19 ± 1.38 ml/min/kg; n = 7) showed 61% and 85% reduction, respectively, compared with those of normal subjects (0.462 ± 0.048 ml/min/kg; n = 5; 41.72 ± 7.75 ml/min/kg; n = 5). Considering that indocyanine green and antipyrine are eliminated by different hepatic mechanisms, these mechanisms may not be equally sensitive to decrements in hepatic function. In addition, fractional reductions of intrinsic clearances for these compounds are thus much greater than that of effective hepatic blood flow.