Detection of Endothelin 2 (Et-2) as a novel biomarker of renal dysfunction in patients of liver Cirrhosis with Ascites

Amna Qureshi, Kalsoom Zaigham, Muhammad Shahzad Iqbal, Qurban Ali


Background: Hepatorenal dysfunction in liver cirrhosis is a condition in which there is progressive kidney failure. It is a serious complication that can lead to death. Endothelin is an endothelial cell-derived peptide which is involved in renal dysfunctioning by generating oxidative stress in individuals suffering from liver cirrhosis. It can be used as important biomarker of hepatorenal dysfunction. The present study was aimed to detect endothelin-2 in the blood of patients of liver cirrhosis with ascites as important biomarker correlated to the generation of oxidative stress and renal dysfunctioning.  

Methods: 50 blood and ascitic fluid samples were collected from the patients of liver cirrhosis with ascites as case group and 25 from normal individuals as control group. Endothelin-2 was detected by PCR in serum and ascetic fluid of patients and its quantification was done by Real-time PCR. ET-2 was quantified in serum samples but was not quantifiable in ascetic fluid might be due to its very low concentration. Blood urea, creatinine and uric acid with GFR were estimated as renal dysfunction parameters. Anti-oxidative enzymes glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MAD) as biomarkers of oxidative stress were estimated in order to calculate oxidative stress. The obtained data was evaluated statistically by using t-test and Pearson correlation.

Results: Positive correlation was found between individual parameters of oxidative stress and renal dysfunction. Overall positive and highly significant (P<0.05) correlation of CAT, SOD, MDA, GSH levels with each other was observed, a significant (P<0.05) and positive correlation of oxidative stress parameters were found with urea, creatinine and uric acid with Glomerular filtration rate (GFR).

Conclusions: It was concluded that the production of ET-2 under oxidative stress generates renal dysfunction in patients of liver cirrhosis with ascites.

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