Schroeder E T, Anderson G H, Smulyan H
Kidney Int. 1979 Jan;15(1):54-61. doi: 10.1038/ki.1979.8.
Ten patients with hepatorenal syndrome were evaluated before and after creation of a side-to-side portacaval shunt or insertion of a peritoneovenous shunt, procedures which produced an increase in plasma volume and cardiac output. In the seven patients who survived surgery, renal function improved significantly, plasma renin activity fell from high to normal levels, and low levels of plasma renin substrate increased. Prior to surgery, blockade of angiotension II by saralasin produced hypotension and an increase in plasma renin activity, whereas after surgery, saralasin had no effect on blood pressure or renin. Our findings suggest that decreased "effective" plasma volume may be important in the stimulation of renin release and possibly in the pathophysiology of renal failure in the hepatorenal syndrome.
对10例肝肾综合征患者在建立侧侧门腔分流术或插入腹腔静脉分流术后进行了评估，这些操作使血浆容量和心输出量增加。在7例手术存活的患者中，肾功能显著改善，血浆肾素活性从高水平降至正常水平，低水平的血浆肾素底物增加。手术前，用沙拉新阻断血管紧张素II会导致低血压并使血浆肾素活性增加，而手术后，沙拉新对血压或肾素没有影响。我们的研究结果表明，“有效”血浆容量减少可能在刺激肾素释放以及肝肾综合征肾衰竭的病理生理学中起重要作用。
