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. 1972 Oct;13(10):763–767. doi: 10.1136/gut.13.10.763

Renal and intrarenal blood flow in non-cirrhotic portal hypertension

M C Kew, Carol Limbrick, R R Varma, Sheila Sherlock
PMCID: PMC1412470  PMID: 5087066

Abstract

The effect of portal hypertension or the consequent portal circulatory changes on renal haemodynamics was studied using the 133xenon washout technique. Renal blood flow was reduced in nine of 11 patients with non-cirrhotic portal hypertension and this was accompanied by a redistribution of intrarenal blood flow, the distribution to and flow rate through the outer cortex being reduced while juxtamedullary and medullary flow was maintained. With slight or moderate decreases in cortical flow glomerular filtration was normal but poor cortical perfusion was associated with low creatinine clearances. These findings raise the possibility that portal hypertension or portal circulatory changes may play a role in the pathogenesis of the renal haemodynamic changes and functional renal failure which frequently complicate advanced hepatic cirrhosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen A. M., Ladefoged J. Partition coefficient of 133-xenon between various tissues and blood in vivo. Scand J Clin Lab Invest. 1967;19(1):72–78. doi: 10.3109/00365516709093483. [DOI] [PubMed] [Google Scholar]
  2. BALDUS W. P., FEICHTER R. N., SUMMERSKILL W. H., HUNT J. C., WAKIM K. G. THE KIDNEY IN CIRRHOSIS. II. DISORDERS OF RENAL FUNCTION. Ann Intern Med. 1964 Mar;60:366–377. doi: 10.7326/0003-4819-60-3-366. [DOI] [PubMed] [Google Scholar]
  3. BALDUS W. P., FEICHTER R. N., SUMMERSKILL W. H. THE KIDNEY IN CIRRHOSIS. I. CLINICAL AND BIOCHEMICAL FEATURES OF AZOTEMIA IN HEPATIC FAILURE. Ann Intern Med. 1964 Mar;60:353–365. doi: 10.7326/0003-4819-60-3-353. [DOI] [PubMed] [Google Scholar]
  4. BALDUS W. P., SUMMERSKILL W. H., HUNT J. C., MAHER F. T. RENAL CIRCULATION IN CIRRHOSIS: OBSERVATIONS BASED ON CATHETERIZATION OF THE RENAL VEIN. J Clin Invest. 1964 Jun;43:1090–1097. doi: 10.1172/JCI104993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Barger A. C., Herd J. A. The renal circulation. N Engl J Med. 1971 Mar 4;284(9):482–490. doi: 10.1056/NEJM197103042840907. [DOI] [PubMed] [Google Scholar]
  6. Barnardo D. E., Summerskill W. H., Strong C. G., Baldus W. P. Renal function, renin activity and endogenous vasoactive substances in cirrhosis. Am J Dig Dis. 1970 May;15(5):419–425. doi: 10.1007/BF02283868. [DOI] [PubMed] [Google Scholar]
  7. Cohn J. N., Tristani F. E., Khatri I. M. Renal vasodilator therapy in the hepatorenal syndrome. Med Ann Dist Columbia. 1970 Jan;39(1):1–7. [PubMed] [Google Scholar]
  8. DOBSON E. L., WARNER G. F. Measurement of regional sodium turnover rates and their application to the estimation of regional blood flow. Am J Physiol. 1957 May;189(2):269–276. doi: 10.1152/ajplegacy.1957.189.2.269. [DOI] [PubMed] [Google Scholar]
  9. Epstein M., Berk D. P., Hollenberg N. K., Adams D. F., Chalmers T. C., Abrams H. L., Merrill J. P. Renal failure in the patient with cirrhosis. The role of active vasoconstriction. Am J Med. 1970 Aug;49(2):175–185. doi: 10.1016/s0002-9343(70)80073-0. [DOI] [PubMed] [Google Scholar]
  10. HILTON J. G., KANTER D. M., HAYS D. R., BOWEN E. H., GOLUB J. R., KEATING J. H., WEGRIA R. The effect of acute arteriovenous fistula on renal functions. J Clin Invest. 1955 May;34(5):732–736. doi: 10.1172/JCI103126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hori M., Austen W. G., McDermott W. V. Role of Hepatic Arterial Blood Flow and Hepatic Nerves on Renal Circulation and Function: I. Acute Studies in the Dog. Ann Surg. 1965 Nov;162(5):849–862. doi: 10.1097/00000658-196511000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kew M. C., Brunt P. W., Varma R. R., Hourigan K. J., Williams H. S., Sherlock S. Renal and intrarenal blood-flow in cirrhosis of the liver. Lancet. 1971 Sep 4;2(7723):504–510. doi: 10.1016/s0140-6736(71)90435-1. [DOI] [PubMed] [Google Scholar]
  13. Koppel M. H., Coburn J. W., Mims M. M., Goldstein H., Boyle J. D., Rubini M. E. Transplantation of cadaveric kidneys from patients with hepatorenal syndrome. Evidence for the functionalnature of renal failure in advanced liver disease. N Engl J Med. 1969 Jun 19;280(25):1367–1371. doi: 10.1056/NEJM196906192802501. [DOI] [PubMed] [Google Scholar]
  14. Lieberman F. L., Reynolds T. B. Plasma volume in cirrhosis of the liver: its relation of portal hypertension, ascites, and renal failure. J Clin Invest. 1967 Aug;46(8):1297–1308. doi: 10.1172/JCI105622. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McCloy R. M., Baldus W. P., Tauxe W. N., Summerskill W. H. Plasma volume and renal circulatory function in cirrhosis. Ann Intern Med. 1967 Feb;66(2):307–311. doi: 10.7326/0003-4819-66-2-307. [DOI] [PubMed] [Google Scholar]
  16. ONNIS M., SHUMACKER H. B., Jr, BOUNOUS G. Response to occlusion of the portal vein. Blood pressure and renal blood flow. Arch Surg. 1962 Dec;85:897–900. doi: 10.1001/archsurg.1962.01310060033008. [DOI] [PubMed] [Google Scholar]
  17. PAPPER S., BELSKY J. L., BLEIFER K. H. Renal failure in Laennec's cirrhosis of the liver. I. Description of clinical and laboratory features. Ann Intern Med. 1959 Oct;51:759–773. doi: 10.7326/0003-4819-51-4-759. [DOI] [PubMed] [Google Scholar]
  18. Reynolds T. B., Lieberman F. L., Redeker A. G. Functional renal failure with cirrhosis. The effect of plasma expansion therapy. Medicine (Baltimore) 1967 Mar;46(2):191–196. doi: 10.1097/00005792-196703000-00011. [DOI] [PubMed] [Google Scholar]
  19. SHEAR L., KLEINERMAN J., GABUZDA G. J. RENAL FAILURE IN PATIENTS WITH CIRRHOSIS OF THE LIVER. I. CLINICAL AND PATHOLOGIC CHARACTERISTICS. Am J Med. 1965 Aug;39:184–198. doi: 10.1016/0002-9343(65)90041-0. [DOI] [PubMed] [Google Scholar]
  20. SUMMERSKILL W. H. Pathogenesis and treatment of disorders of water and electrolyte metabolism in hepatic disease. Proc Staff Meet Mayo Clin. 1960 Mar 2;35:89–97. [PubMed] [Google Scholar]
  21. Schroeder E. T., Numann P. J., Chamberlain B. E. Functional renal failure in cirrhosis. Recovery after portacaval shunt. Ann Intern Med. 1970 Jun;72(6):923–928. doi: 10.7326/0003-4819-72-6-923. [DOI] [PubMed] [Google Scholar]
  22. Schroeder E. T., Shear L., Sancetta S. M., Gabuzda G. J. Renal failure in patients with cirrhosis of the liver. 3. Evaluation of intrarenal blood flow by para-aminohippurate extraction and response to angiotensin. Am J Med. 1967 Dec;43(6):887–896. doi: 10.1016/0002-9343(67)90247-1. [DOI] [PubMed] [Google Scholar]
  23. TANCHE M., LEMARCHANDS H. Un mécanisme possible de l'arrêt de la diurèse consécutif à l'interruption de la circulation porte. J Physiol (Paris) 1958 Mar;50(2):538–540. [PubMed] [Google Scholar]
  24. Tristani F. E., Cohn J. N. Systemic and renal hemodynamics in oliguric hepatic failure: effect of volume expansion. J Clin Invest. 1967 Dec;46(12):1894–1906. doi: 10.1172/JCI105679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. VLAHCEVIC Z. R., ADHAM N. F., JICK H., MOORE E. W., CHALMERS T. C. RENAL EFFECTS OF ACUTE EXPANSION OF PLASMA VOLUME IN CIRRHOSIS. N Engl J Med. 1965 Feb 25;272:387–390. doi: 10.1056/NEJM196502252720802. [DOI] [PubMed] [Google Scholar]
  26. Vesin P., Roberti A., Viguié R. Défaillance rénale fonctionnelle terminale chez des malades atteints de cancer du foie, primitif ou secondaire. Sem Hop. 1965 Apr 26;41(20):1216–1220. [PubMed] [Google Scholar]

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