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Abstract

The first abnormality leading to sodium and water retention in cirrhosis is the renal tubular defect that is related to deteriorating liver function and hyperaldosteronism. With progression of liver disease and portal hypertension, renal blood flow declines because of the hepatorenal reflex, and is then maintained by the vasoactive hormonal systems. With increasing peripheral vasodilatation, intrarenal factors for maintenance of renal perfusion cause intense cortical vasoconstriction. The systemic vasoactive factors are predominantly compensatory; any attempts to counteract their action risk circulatory collapse. Future studies should be directed at intrarenal factors. The ideal drug for the treatment of portal hypertension would reduce portal pressure, increase renal blood flow, and produce insignificant changes in arterial pressure.

Details

Title
Hepatic encephalopathy and ascites
Author
Jalan, Rajiv; Hayes, Peter C
Pages
1309-15
Publication year
1997
Publication date
Nov 1, 1997
Publisher
Elsevier Limited
ISSN
01406736
e-ISSN
1474547X
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
199007070
Copyright
Copyright Lancet Ltd. Nov 1, 1997