A retrospective comparison of functional renal failure in cirrhosis treated by conventional therapy or the peritoneo-venous shunt (LeVeen).

Between 1973 to 1976, 12 ascitic cirrhotic patients with a mean plasma creatinine (pCr) of 4.4 +/- 3.0 mg/dl) were treated conservatively. During the same period 11 cirrhotics with ascites (pCr 4.3 +/- 2.8 mg/dl) were treated with LeVeen peritoneal jugular shunt. In the medically treated group mean survival was 2.4 +/- 2.7 weeks after detection of pCr elevation greater than 2.3 mg/dl. The 11 surgical patients with pCr elevation above 2.3 mg/dl survived a mean of 21.8 +/- 34.5 weeks after surgery. Four patients survived more than six months. The LeVeen shunt also resulted in significant weight loss, reduction in blood urea nitrogen (BUN), elevation of serum sodium, and increase of renal clearance of sodium. In appropriately selected patients it reverses the hepato-renal syndrome.