THE RENIN- ANGIOTENSIN- ALDOSTERONE SYSTEM IN HEPATORENAL SYNDROME
Soha Zaky El-Shennawy;
Abstract
Hepatorenal syndrome is still one of the most important challenges of medicine in the 21st century.
It is defined as functional renal failure in advanced cirrhosis and ascites. Morphologic abnormalities of the kidneys are frequently absent and tubular function is preserved. Patients with the hepatorenal syndrome are characterized by progressive splanchnic and systemic vasodilatation and decreased effective arterial blood volume. Compensatory activation of vasoconstrictory systems maintains systemic hemodynamic stability but causes progressive afferent renal vasoconstriction, leading to reduction of glomerular filtration rate. Renal failure may be rapidly progressive (type I hepatorenal syndrome, frequently associated with spontaneous bacterial peritonitis) or may develop more slowly (type II).
One of the major vasoconstrictor factors that regulate renal perfusion
is the renin-angiotensin-aldosterone system. It was an important factor to . be considered as potential mediators of renal vasoconstriction in HRS.
For these reasons, this study was planned to show the level of plasma renin activity, plasma All and serum aldosterone in hepatorenal syndrome patients compared to each of ascitic patients, cirrhotic patients and control subjects to assess if they have a role in the pathogenesis of
HRS.
The study was carried out on 67 subjects (49 males and 18 females) from National Liver Institute.
It is defined as functional renal failure in advanced cirrhosis and ascites. Morphologic abnormalities of the kidneys are frequently absent and tubular function is preserved. Patients with the hepatorenal syndrome are characterized by progressive splanchnic and systemic vasodilatation and decreased effective arterial blood volume. Compensatory activation of vasoconstrictory systems maintains systemic hemodynamic stability but causes progressive afferent renal vasoconstriction, leading to reduction of glomerular filtration rate. Renal failure may be rapidly progressive (type I hepatorenal syndrome, frequently associated with spontaneous bacterial peritonitis) or may develop more slowly (type II).
One of the major vasoconstrictor factors that regulate renal perfusion
is the renin-angiotensin-aldosterone system. It was an important factor to . be considered as potential mediators of renal vasoconstriction in HRS.
For these reasons, this study was planned to show the level of plasma renin activity, plasma All and serum aldosterone in hepatorenal syndrome patients compared to each of ascitic patients, cirrhotic patients and control subjects to assess if they have a role in the pathogenesis of
HRS.
The study was carried out on 67 subjects (49 males and 18 females) from National Liver Institute.
Other data
| Title | THE RENIN- ANGIOTENSIN- ALDOSTERONE SYSTEM IN HEPATORENAL SYNDROME | Other Titles | نظام الرينين – الانجوتينسين – الالدوستيرون في مرضى الفشل الكبدي الكلوي | Authors | Soha Zaky El-Shennawy | Issue Date | 2004 |
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