Effects of ulinastatin on postoperative renal function in hepatectomized patients with liver cirrhosis

Abstract Posthepatectomy patients with liver cirrhosis have a high incidence of multiple organ failure including renal failure. The depression of urinary ulinastatin (UTI) might be involved in renal derangements in the posthepatectomy patients with liver cirrhosis. We evaluated the relationship between the renal functions and the level of urinary UTI in perioperative period in the posthepatectomy patients with liver cirrhosis, and evaluated whether or not the renal function in the posthepatectomy patients with liver cirrhosis was protected by receiving synthetic UTI, Miraclid. In posthepatectomy patients with liver cirrhosis, the urinary UTI level was 26.3 +/- 13.0 IU. mg x Cr-1 on the first day and renal tubular dysfunction was noticed. On the other hand, in posthepatectomy patients with liver cirrhosis receiving Miraclid administered intravenously during the operation and postoperative three days, the urinary UTI level was 121.2 +/- 85.0 IU. mg x Cr-1 on the first day and renal function was maintained. These results indicate that in posthepatectomy patients with liver cirrhosis, an increase in urinary UTI level observed in response to surgical stress may not occur and this low level of urinary UTI may cause renal dysfunction in the postoperative period. The synthetic UTI, Miraclid, may have beneficial effects reversing the renal derangements resulting from the stress in posthepatectomy patients with liver cirrhosis.