Hepatorenal syndrome: insights into the mechanisms of intra-abdominal hypertension.
OBJECTIVE
Hepatorenal syndrome is one of the serious complications of cirrhosis and closely associated with the increasing intra-abdominal pressure (IAP). The study aims to explore the potential mechanism of intra-abdominal hypertension in the development of hepatorenal syndrome in mouse models.


METHODS
Eighty male mice were randomly divided into model group (subcutaneous injection of carbon tetrachloride) and control group (subcutaneous injection of olive oil). After 12 weeks, parts of the mice were sacrificed and liver histopathology was detected. Then, albumin (30 g/L) and normal saline were separately injected into the peritoneal cavity of mice to induce the different IAP levels (0, 5, 10 and 20cmH2O). Blood urea nitrogen, serum creatinine and renal histopathology were examined 24 hours later.


RESULTS
Blood urea nitrogen and serum creatinine levels were statistically significant high in the group of IAP= 10 and 20cmH2O as compared with the IAP= 0cmH2O. From results of renal histopathology, the constrictive renal tubular lumen and inflammatory infiltration in the interstitial were observed in groups of IAP= 5 and 10cmH2O. Besides, the formed casts and hyperemia in the renal interstitial could be detected in group of IAP= 20cmH2O. The cellular swelling and edema of renal tubular epithelial cells were found in model group simultaneously.


CONCLUSIONS
Our study suggested that intra-abdominal hypertension was a significant pathological mechanism and a potential independent risk factor of hepatorenal syndrome.
Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
Yizhong
Y
Chang
Xiaolong
X
Qi
Zhiwei
Z
Li
Fei
F
Wang
Shenglan
S
Wang
Zhaojie
Z
Zhang
Chaohui
C
Xiao
Tongling
T
Ding
Changqing
C
Yang
D000418:Albumins; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D002251:Carbon Tetrachloride; D003404:Creatinine / Q000097:blood; D006530:Hepatorenal Syndrome / Q000097:blood / Q000209:etiology* / Q000473:pathology; D059325:Intra-Abdominal Hypertension / Q000097:blood / Q000139:chemically induced / Q000150:complications* / Q000473:pathology; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008106:Liver Cirrhosis, Experimental / Q000139:chemically induced / Q000150:complications; D008297:Male; D051379:Mice; D008813:Mice, Inbred ICR; D011312:Pressure; D012307:Risk Factors; D012965:Sodium Chloride
D000418:Albumins; D015415:Biomarkers; D012965:Sodium Chloride; D003404:Creatinine; D002251:Carbon Tetrachloride
Intra-abdominal hypertension; abdominal compartment syndrome; cirrhosis; hepatorenal syndrome