Increased plasma levels of neuropeptide Y in hepatorenal syndrome.
OBJECTIVE
To investigate the relationship between neuropeptide Y (NPY), a potent renal vasoconstrictor peptide released upon marked stimulations of sympathetic nervous system (SNS), and renal and circulatory function in cirrhosis.


METHODS
Plasma levels of NPY (radioimmunoassay) and norepinephrine and renal function parameters were determined in 17 healthy controls, nine patients with cirrhosis without ascites, and 37 patients with cirrhosis and ascites, of whom 12 had hepatorenal syndrome (HRS).


RESULTS
Patients with ascites showed circulating levels of NPY similar to those of patients without ascites and controls (73+/-4, +/-4 and 68+/-4 pmol/l, respectively; NS). However, patients with HRS had significantly increased levels of NPY with respect to the other groups (110+/-6 pmol/l; P<0.001). NPY levels correlated inversely with renal plasma flow and glomerular filtration rate and directly with norepinephrine. In patients with HRS (n=6) treatment with terlipressin and albumin was associated with a marked improvement in circulatory and renal function and marked suppression of NPY and norepinephrine levels.


CONCLUSIONS
Patients with HRS have increased levels of NPY which are related to circulatory dysfunction and SNS activation and may contribute to renal vasoconstriction.
Uriz
Juan
J
Liver Unit, Institut de Malalties Digestives, Hospital Clínic, Barcelona, Spain.
Ginès
Pere
P
Ortega
Rolando
R
Jiménez
Wladimiro
W
Cárdenas
Andrés
A
Calahorra
Blas
B
Sort
Pau
P
Fernández
Javier
J
Bataller
Ramón
R
Arroyo
Vicente
V
Rivera
Francisca
F
Rodés
Juan
J
D001201:Ascites / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006530:Hepatorenal Syndrome / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009478:Neuropeptide Y / Q000097:blood*; D009638:Norepinephrine / Q000097:blood; D012079:Renal Circulation / Q000502:physiology; D014661:Vasoconstriction / Q000502:physiology
D009478:Neuropeptide Y; D003404:Creatinine; D009638:Norepinephrine