Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites
Increased circulating noradrenaline in patients with cirrhosis is due to enhanced sympathetic nervous activity and is not merely the result of decreased clearance of catecholamines. There is a direct relation between the level of arterial norndrenaline and severity of cirrhosis, increased portal pre...
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| Format: | Article |
| Language: | English |
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Wiley
1991-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/1991/245757 |
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| author | Jens H Henriksen Helmer Ring-Larsen Niels Juel Christensen |
| author_facet | Jens H Henriksen Helmer Ring-Larsen Niels Juel Christensen |
| author_sort | Jens H Henriksen |
| collection | DOAJ |
| description | Increased circulating noradrenaline in patients with cirrhosis is due to enhanced sympathetic nervous activity and is not merely the result of decreased clearance of catecholamines. There is a direct relation between the level of arterial norndrenaline and severity of cirrhosis, increased portal pressure and fluid accumulation; patients with the hepatorenal syndrome exhibit the highest values of plasma noradrenaline. In patients with cirrhosis, the kidneys have been identified as an important source of noradrenaline ‘spillover’ into plasma, which indicates enhanced
sympathetic nervous activity in these organs. Moreover, the level of plasma noradrenaline is inversely related to renal bloodflow and urinary excretion of sodium, and directly related to plasma renin, vasopressin and aldosterone. An increased spillover of noradrenaline has recently been demonstrated in the splanchnic system and superior portosystemic collaterals. Reduced central and arterial blood volume and low arterial blood pressure secondary to peripheral vasodilation are probably important afferent stimuli for enhanced sympathetic nervous activity, although a nonvolume-dependent hepatic baroreceptor may
also be present. The authors conclude that the sympathetic nervous system, in concert with other regulatory systems, plays an important role in sodium-water homeostasis and fluid retention, as well as in the systemic and hepatosplanchnic circulatory derangement seen in patients with cirrhosis. |
| format | Article |
| id | doaj-art-e741723ec6f146528f8bed1d65361271 |
| institution | Kabale University |
| issn | 0835-7900 |
| language | English |
| publishDate | 1991-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology |
| spelling | doaj-art-e741723ec6f146528f8bed1d653612712025-02-03T05:58:08ZengWileyCanadian Journal of Gastroenterology0835-79001991-01-015310311110.1155/1991/245757Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of AscitesJens H Henriksen0Helmer Ring-Larsen1Niels Juel Christensen2Departments of Clinical Pysiology and Hepatology, Hvidovre Hospital, and Department of Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, DenmarkDepartments of Clinical Pysiology and Hepatology, Hvidovre Hospital, and Department of Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, DenmarkDepartments of Clinical Pysiology and Hepatology, Hvidovre Hospital, and Department of Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, DenmarkIncreased circulating noradrenaline in patients with cirrhosis is due to enhanced sympathetic nervous activity and is not merely the result of decreased clearance of catecholamines. There is a direct relation between the level of arterial norndrenaline and severity of cirrhosis, increased portal pressure and fluid accumulation; patients with the hepatorenal syndrome exhibit the highest values of plasma noradrenaline. In patients with cirrhosis, the kidneys have been identified as an important source of noradrenaline ‘spillover’ into plasma, which indicates enhanced sympathetic nervous activity in these organs. Moreover, the level of plasma noradrenaline is inversely related to renal bloodflow and urinary excretion of sodium, and directly related to plasma renin, vasopressin and aldosterone. An increased spillover of noradrenaline has recently been demonstrated in the splanchnic system and superior portosystemic collaterals. Reduced central and arterial blood volume and low arterial blood pressure secondary to peripheral vasodilation are probably important afferent stimuli for enhanced sympathetic nervous activity, although a nonvolume-dependent hepatic baroreceptor may also be present. The authors conclude that the sympathetic nervous system, in concert with other regulatory systems, plays an important role in sodium-water homeostasis and fluid retention, as well as in the systemic and hepatosplanchnic circulatory derangement seen in patients with cirrhosis.http://dx.doi.org/10.1155/1991/245757 |
| spellingShingle | Jens H Henriksen Helmer Ring-Larsen Niels Juel Christensen Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites Canadian Journal of Gastroenterology |
| title | Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites |
| title_full | Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites |
| title_fullStr | Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites |
| title_full_unstemmed | Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites |
| title_short | Sympathetic Nervous Regulation in Patients with Cirrhosis: Pathogenesis of Fluid Retention and Formation of Ascites |
| title_sort | sympathetic nervous regulation in patients with cirrhosis pathogenesis of fluid retention and formation of ascites |
| url | http://dx.doi.org/10.1155/1991/245757 |
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