Document Detail

Systemic hemodynamics and renal function in cirrhotic patients during plasma volume expansion.
MedLine Citation:
PMID:  6195037     Owner:  NLM     Status:  MEDLINE    
Systemic hemodynamic impairment (hepatocirculatory failure) has been suggested as one of the possible factors which may explain the renal hemodynamic alterations found in the late stage of liver cirrhosis, typical of the hepatorenal syndrome. 20 patients, divided into two groups of 10 sodium retainers and 10 sodium excretors, affected by liver cirrhosis with portal hypertension and ascites, were studied. Renal functional parameters (diuresis, urinary and plasma electrolytes, urine to plasma osmolality and creatinine ratios and creatinine clearance) were evaluated before and after acute volume expansion with 1,000 ml of 10% dextran in saline, infused through a catheter located in the right atrium. Hemodynamic tests (cardiac index, systemic vascular resistance, right atrial pressure and capillary wedge pressure) were performed before, during and after expansion. Cardiac index decreased in 6 patients (sodium excretors) after a 500-ml infusion and rose again after 1,000 ml in 5 of them. The remaining 14 patients showed a progressive and significant increase of cardiac index. A strong inverse relationship between cardiac index and systemic vascular resistance was observed (r = -0.87; p less than 0.001). The mean left-ventricular function curve showed a slow response in most sodium excretors and a normal response in the sodium-retaining group, without significant difference between the two groups. Sodium excretion significantly improved after expansion in both groups of patients. No relationship was found between hemodynamic response and renal function. These data show that cardiocirculatory function is normal, even in sodium-retaining cirrhotics.
P Gentilini; G Laffi; F Fantini; M di Donato; R P Dabizzi; G La Villa; M Pinzani; G Buzzelli; C Smorlesi; A Pampana
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Digestion     Volume:  27     ISSN:  0012-2823     ISO Abbreviation:  Digestion     Publication Date:  1983  
Date Detail:
Created Date:  1983-12-21     Completed Date:  1983-12-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  138-45     Citation Subset:  IM    
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MeSH Terms
Body Surface Area
Cardiac Output / drug effects
Dextrans / pharmacology,  therapeutic use*
Heart Ventricles / physiopathology
Hemodynamics / drug effects*
Kidney / physiopathology*
Kidney Function Tests
Liver Cirrhosis / physiopathology*,  therapy
Middle Aged
Natriuresis / drug effects
Pulmonary Wedge Pressure / drug effects
Vascular Resistance / drug effects
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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