Hemodynamic, neurohumoral, and metabolic responses to amino acid infusion in patients with cirrhosis.
In patients with cirrhosis the renal response to amino acid infusion is controversial. In addition, the renal and systemic metabolic effects of amino acids are unknown. Therefore, the present study examined the effects of amino acids on renal hemodynamics, renal and systemic oxygen (O2) consumption, and hormones in patients with cirrhosis. Twelve patients received an 8% amino acid solution for 30 minutes at a rate providing 250 mg of amino acids/kg body wt. Renal blood flow increased by 45% (P less than 0.05) and the glomerular filtration rate by only 9% (P greater than 0.05). Renal vascular resistance decreased by 23% (P less than 0.05), and renal perfusion pressure did not change significantly. Renal and systemic O2 consumption and pulmonary artery plasma glucagon level significantly increased. There were no significant changes in plasma osmolality, plasma volume, and plasma atrial natriuretic peptide concentrations. In conclusion, the results show that amino acid-induced renal vasodilation caused hyperperfusion but not renal hyperfiltration in patients with cirrhosis. In addition, renal hyperemia was associated with renal and systemic hypermetabolism.
Moreau
R
R
Laboratoire d'Hémodynamique Splanchnique, Hôpital Beaujon, Clichy, France.
Soubrane
O
O
Sogni
P
P
Hadengue
A
A
Gaudin
C
C
Lin
H C
HC
Pussard
E
E
Nahoul
K
K
Lebrec
D
D
D000596:Amino Acids / Q000494:pharmacology*; D009320:Atrial Natriuretic Factor / Q000097:blood; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*
D000596:Amino Acids; D008353:Mannitol; D009320:Atrial Natriuretic Factor