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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Increased incidence of renal insufficiency is observed in severe damage of liver parenchyma such as fulminant hepatitis, decompensated cirrhosis of the liver, septic cholangitis and the different forms of obstructive jaundice. Functional circulatory disturbances of the kidney, especially of the renal cortex, are of importance in the aetiology of this condition. Dopamine, at a dosage as low as 3 gamma/kg/min leads to an improvement in renal blood flow and also to an increase in hepatic blood flow. These observations are of therapeutic importance. Some important circulatory and functional parameters of both these organs, which influence each other under normal and pathological conditions, were studied in the presence of dopamine and the following results were obtained: 1. An investigation of the intrarenal haemodynamics with 133 Xenon in patients with severe cirrhosis of the liver and in patients with obstructive jaundice resulted in an increase of 91% in the mean renal blood flow. The blood flow in the renal cortex increased by 36.2% and in the renal medulla 18.5%, whereas the renal fat tissue showed no change. Compartment I, which was diminished as compared with the control value, also increased. The percentage contribution of the mean renal blood flow and the blood flow of the renal cortex towards the cardiac output was greater under the influence of dopamine; hence a greater part of the cardiac output flows into the kidney under dopamine. 2. The glomerular filtrate and the renal plasma flow increased under dopamine (13.5% and 43.1%, respectively). The increase was greater in compensated than in decompensated cirrhosis. In patients with obstructive jaundice there was a smaller increase in both these parameters than in patients with cirrhosis in the presence of dopamine. No connection was found between the increase in renal plasma flow with dopamine and the blood levels of bilirubin, cholinesterase, GOT and the Normotest. 3. The urinary output of sodium increased by 191.4% with dopamine. Patients with an initial renal plasma flow value of over 300 ml/min had a higher sodium output. These patients also eliminated more sodium under the influence of dopamine than those with an initial renal plasma flow value of under 300 ml/min. 4. Blood flow determinations in the portal vein and the hepatic artery in man, obtained during operation, showed an increase in portal flow of 28.5% and hepatic artery flow of 6.3% in response to dopamine. The percentage contribution of portal blood flow towards the cardiac output increase on dopamine administration. The functional hepatic blood flow, analyzed with 131-J-BSP, did not change. The wedged hepatic vein pressure, which is a good measure of portal pressure, increased on average by only 7% with dopamine at a dosage of 3 gamma/kg/min, but by 20.3% with twice the dosage. Dopamine did not cause a change in hepatic blood volume; hence, blood sequestration in the liver can be excluded in response to the dopamine-evoked increase in portal blood flow. 5...
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PMID:[Clinical and experimental investigations of the effect of dopamine on haemodynamics and function of kidney and liver (author's transl)]. 27 63

The literature data concerning respiratory function in cirrhosis of the liver are cited and reference is made to the results of a spirometric, gas analysis and 133-Xenon investigation of this parameter in 38 patients. Spirometry pointed to slight ventilatory incapacity of the restrictive type. Arterial gas analaysis showed respiratory alkalosis, usually accompanied by metabolic acidosis and slight hypoxyaemia. Examination with 133-Xe indicated that hypoxyaemia was not due to a shunt effect, since there was no excess of perfusion with respect to district ventilation. It was clear, on the other hand, that the pulmonary capillary reserve was almost exhausted. Such complete perfusion of the capillary bed may be due to increased cardiac output and, in part, to reduction of the respiratory surface caused by raising of the diaphragm and hypoventilation of the lung bases.
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PMID:[Respiratory function in liver cirrhosis. Spirometry, blood gas analysis and radioisotope study with Xenon 133]. 111 19

Cerebral blood flow (CBF), measured by the non-invasive 133-Xenon inhalation method, plasma levels of ammonia (NH3) and free tryptophan (fTRP) were determined in 30 cirrhotic patients without overt encephalopathy. Psychometric evaluation detected subclinical hepatic encephalopathy (SHE) in 20 of them, and was normal in the other 10. A significant CBF difference (p less than 0.05) was found between the SHE and the non-SHE patients. fTRP levels were significantly (p less than 0.05) higher in patients with SHE than in those without SHE, and a significant negative correlation (p = 0.003) was found between CBF values and fTRP in the whole group of patients. NH3 did not differ in the two subgroups and did not correlate with CBF values. It is concluded that CBF could have some implications in SHE, although its relevance is still unclear. The negative correlation between CBF and fTRP prompts further investigation concerning the relationships between plasma fTRP, brain serotonin, cerebral metabolism and blood flow in the development of brain derangement during cirrhosis.
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PMID:Cerebral blood flow and plasma free tryptophan in cirrhotics with and without hepatic encephalopathy. 279 14

Hepatic blood flow (HBF; ml/min/g of liver) has been measured in Wistar rats with a Xenon 133 washout method. The hepatic arterial blood flow (HABF) which amounts to 23 +/- 3% of the total HBF increases immediately after occlusion of the portal vein to ensure 36 +/- 4% of the control HBF, but continues to increase progressively for the next 4 h to furnish 69 +/- 5% of the control HBF. This represents a 183 +/- 16% increase of the control HABF. Thereafter, the liver starts to atrophy, whereas the total liver blood flow remains constant. Thus, the HBF increases and 30 days later does not differ significantly from the control value. Similar experiments were performed in rats in which cirrhosis was induced by CCl4. The HBF is decreased and the contribution of the hepatic artery raised. After portacaval shunting, the increase of the HABF, although less pronounced, is also progressive and takes 4 h to reach its maximum.
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PMID:Progressive hepatic arterial flow increase after end-to-side portacaval shunt in normal and cirrhotic rats. 378 Jul 89

There was no significant difference in forearm muscle blood flow, measured by the clearance of (133)Xenon when 38 patients with liver disease were compared with 38 normal subjects. Patients with a clinically hyperdynamic circulation, finger clubbing, and previous portocaval anastomoses were included in the study. The changes in forearm skeletal muscle blood flow and pulse rate caused by a head-up tilt of 70 degrees were measured in 15 patients with chronic liver disease and 15 age-matched controls. Head-up tilting resulted in significantly less peripheral vasoconstriction and tachycardia in the group with liver disease than in the control group. These results suggest an impairment of baroreceptor-mediated sympathetic reactivity in liver disease. Such a defect might explain the relative rarity of hypertension in patients with cirrhosis.
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PMID:Skeletal muscle blood flow and neurovascular reactivity in liver disease. 471 2

Although functional renal failure has been reported in patients with malignant disease of the liver, renal haemodynamics and function have not been investigated. Renal and intrarenal blood flow was measured using the (133)Xenon washout technique and creatinine clearances by the standard method in 14 patients with a variety of primary and secondary tumours of the liver in the absence of cirrhosis and without evidence of renal disease. In 11 patients renal and outer cortical blood flow was reduced and this was sometimes accompanied by a reduction in glomerular filtration rate. The pattern of renal circulatory changes was similar to that seen in renal dysfunction associated with hepatic cirrhosis. Possible causes of these disturbances and their significance in relation to the aetiology of functional renal failure in liver disease are discussed.
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PMID:Renal blood flow in malignant disease of the liver. 504 Aug 31

In 18 cirrhotics with impaired renal perfusion intravenous injection of aminophylline 3 mg/kg b.w. increased mean renal blood flow (133-Xenon washout) from 1.77 +/- 0.71 to 1.99 +/- 0.44 ml/g/min (p less than 0.01). No significant change in cardiac output was found. In a further 10 cirrhotic patients the administration of aminophylline 3 mg/kg decreased the mean tubular reabsorption of sodium in the proximal section of the nephron (distal delivery) from 10.5 +/- 6.2 to 16.3 +/- 16.5 (p less than 0.01). Free-water production increased as a consequence of the increased supply of sodium to the diluting segment. Thus, aminophylline acts favourably on the functional renal impairment that occurs in hepatic cirrhosis.
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PMID:Renal effects of aminophylline in hepatic cirrhosis. 688 12

Regional hepatic blood flow was measured by two methods using 133-Xenon washout technique: 1. "portal method" (injection of 133-Xenon into the spleen), and 2. "arterial method" (direct application of 133-Xenon into the A. hepatica propria by an indwelling catheter after celiacography). The portal method was performed in 38 patients (30 patients with cirrhosis of the liver, 4 patients with chronic hepatitis, 4 controls with normal liver function). The results show that using this method regional liver blood flow can be measured accurately. Patients with cirrhosis of the liver had a highly significantly decreased hepatic blood flow in comparison to the control group. The advantage of this method is that extra- and intrahepatic shunts can be visualized simultaneously. However, using this method in patients with hemodynamically very effective extrahepatic collaterals the tracer does not reach the liver. In these patients regional hepatic blood flow can be estimated by the arterial method (12 patients with cirrhosis of the liver, 2 with normal liver function). However, no information about the morphology of the portal circulation can be obtained using this method. Direct comparison of the quantitative estimation of regional hepatic blood flow was performed in 6 patients. The data obtained by the 2 methods correlated highly significantly (r = 0.91).
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PMID:[Estimation of hepatic blood flow with 133-Xenon (author's transl)]. 719 7

The progression of chronic liver disease differs by etiology. The aim of this study was to elucidate the difference in disease progression between chronic hepatitis C (CHC) and nonalcoholic fatty liver disease (NAFLD) by means of fibrosis markers, liver function, and hepatic tissue blood flow (TBF). Xenon computed tomography (Xe-CT) was performed in 139 patients with NAFLD and 152 patients with CHC (including liver cirrhosis (LC)). The cutoff values for fibrosis markers were compared between NAFLD and CHC, and correlations between hepatic TBF and liver function tests were examined at each fibrosis stage. The cutoff values for detection of the advanced fibrosis stage were lower in NAFLD than in CHC. Although portal venous TBF (PVTBF) correlated with liver function tests, PVTBF in initial LC caused by nonalcoholic steatohepatitis (NASH-LC) was significantly lower than that in hepatitis C virus (C-LC) (p = 0.014). Conversely, the liver function tests in NASH-LC were higher than those in C-LC (p < 0.05). It is important to recognize the difference between NAFLD and CHC. We concluded that changes in hepatic blood flow occurred during the earliest stage of hepatic fibrosis in patients with NAFLD; therefore, patients with NAFLD need to be followed carefully.
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PMID:Correlations of Hepatic Hemodynamics, Liver Function, and Fibrosis Markers in Nonalcoholic Fatty Liver Disease: Comparison with Chronic Hepatitis Related to Hepatitis C Virus. 2764 52