Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis
In cirrhosis of the liver, according to the peripheral arterial vasodilation hypothesis, relative underfilling of the arterial tree triggers a neurohumoral response (activation of renin-angiotensinaldosterone system, sympathetic nervous system, nonosmotic release of vasopressin) aimed at restoring c...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2000-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2000/340128 |
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| _version_ | 1832552803738845184 |
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| author | Mladen Knotek Boris Rogachev Robert W Schrier |
| author_facet | Mladen Knotek Boris Rogachev Robert W Schrier |
| author_sort | Mladen Knotek |
| collection | DOAJ |
| description | In
cirrhosis of the liver, according to the peripheral arterial vasodilation
hypothesis, relative underfilling of the arterial tree triggers a
neurohumoral response (activation of renin-angiotensinaldosterone
system, sympathetic nervous system, nonosmotic release
of vasopressin) aimed at restoring circulatory integrity by
promoting renal sodium and water retention. Evidence has accumulated
for a major role of increased vascular production of nitric
oxide as the primary cause of arterial vasodilation in cirrhosis. Ascites
is a common complication in cirrhosis. Treatment of ascites
consists of a low salt diet with diuretics, and paracentesis together
with plasma volume expanders in diuretic-resistant patients. Progression
of cirrhosis may result in hepatorenal syndrome, a state of
functional renal failure that carries an ominous prognosis. Orthotopic
liver transplantation has remained the only curative treatment
for patients with advanced liver disease; other modalities
such as transjugular intrahepatic portosystemic shunt or vasopressin
analogues may serve as a bridge to transplantation. Another
complication of decompensated cirrhosis is spontaneous
bacterial peritonitis, the incidence of which can be reduced by primary
or secondary antibiotic prophylaxis by using orally active antibiotics. |
| format | Article |
| id | doaj-art-b853112be587418e8752c6ed17693b4f |
| institution | Kabale University |
| issn | 0835-7900 |
| language | English |
| publishDate | 2000-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology |
| spelling | doaj-art-b853112be587418e8752c6ed17693b4f2025-02-03T05:57:50ZengWileyCanadian Journal of Gastroenterology0835-79002000-01-0114Suppl D112D121D10.1155/2000/340128Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in CirrhosisMladen Knotek0Boris Rogachev1Robert W Schrier2Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USADepartment of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USADepartment of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USAIn cirrhosis of the liver, according to the peripheral arterial vasodilation hypothesis, relative underfilling of the arterial tree triggers a neurohumoral response (activation of renin-angiotensinaldosterone system, sympathetic nervous system, nonosmotic release of vasopressin) aimed at restoring circulatory integrity by promoting renal sodium and water retention. Evidence has accumulated for a major role of increased vascular production of nitric oxide as the primary cause of arterial vasodilation in cirrhosis. Ascites is a common complication in cirrhosis. Treatment of ascites consists of a low salt diet with diuretics, and paracentesis together with plasma volume expanders in diuretic-resistant patients. Progression of cirrhosis may result in hepatorenal syndrome, a state of functional renal failure that carries an ominous prognosis. Orthotopic liver transplantation has remained the only curative treatment for patients with advanced liver disease; other modalities such as transjugular intrahepatic portosystemic shunt or vasopressin analogues may serve as a bridge to transplantation. Another complication of decompensated cirrhosis is spontaneous bacterial peritonitis, the incidence of which can be reduced by primary or secondary antibiotic prophylaxis by using orally active antibiotics.http://dx.doi.org/10.1155/2000/340128 |
| spellingShingle | Mladen Knotek Boris Rogachev Robert W Schrier Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis Canadian Journal of Gastroenterology |
| title | Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis |
| title_full | Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis |
| title_fullStr | Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis |
| title_full_unstemmed | Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis |
| title_short | Update on Peripheral Arterial Vasodilation, Ascites and Hepatorenal Syndrome in Cirrhosis |
| title_sort | update on peripheral arterial vasodilation ascites and hepatorenal syndrome in cirrhosis |
| url | http://dx.doi.org/10.1155/2000/340128 |
| work_keys_str_mv | AT mladenknotek updateonperipheralarterialvasodilationascitesandhepatorenalsyndromeincirrhosis AT borisrogachev updateonperipheralarterialvasodilationascitesandhepatorenalsyndromeincirrhosis AT robertwschrier updateonperipheralarterialvasodilationascitesandhepatorenalsyndromeincirrhosis |