Vasoactive factors in decompensated cirrhosis. Effect of acute plasma expansion.
Plasma volume expansion was performed in 16 cirrhotic patients with ascites, 8 with avid sodium retention (sodium retainers) and 8 with normal sodium balance (sodium excretors). No natriuretic response was observed in sodium retainers (daily UNa = 7.1 +/- 1.5 mEq before expansion and 20.8 +/- 7.8 after expansion; p = not significant). After expansion plasma renin activity and plasma aldosterone showed a fall in both groups, whereas urinary kallikrein excretion decreased significantly in sodium retainers (27.1 +/- 9.7 before expansion and 7.8 +/- 6.4 after expansion; p less than 0.05). Baseline PGE were higher than normal in sodium retainers (997.0 +/- 134.3; p less than 0.02 vs. controls) and increased after expansion. Plasma octopamine was always within normal range. These results suggest that: a) reduction of effective plasma volume is not the main factor involved in sodium retention; b) the renin-angiotensin-aldosterone system has only a permissive role; c) prostaglandin system is activated and could have a protective role in maintaining renal function in cirrhotic patients.
D000328:Adult; D000450:Aldosterone / Q000097:blood; D001810:Blood Volume; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007610:Kallikreins / Q000652:urine; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009318:Natriuresis; D011458:Prostaglandins E / Q000097:blood; D012084:Renin-Angiotensin System
D011458:Prostaglandins E; D000450:Aldosterone; D003404:Creatinine; D007610:Kallikreins