Effects of ursodeoxycholic acid on systemic, renal and forearm haemodynamics and sodium homoeostasis in cirrhotic patients with refractory ascites

1999 ◽  
Vol 96 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Florence WONG ◽  
Arieh BOMZON ◽  
Johane ALLARD ◽  
Peter LIU ◽  
Laurence BLENDIS
Keyword(s):  
Lipid Peroxidation ◽  
Liver Function ◽  
Ursodeoxycholic Acid ◽  
Sodium Excretion ◽  
Refractory Ascites ◽  
Sodium Retention ◽  
Lipid Peroxidation Products ◽  
Cirrhotic Patients ◽  
Antioxidant Effects ◽  
Sodium Handling

Systemic arterial vasodilatation has been implicated in the pathogenesis of sodium retention in cirrhosis. Hydrophobic bile acids, which have vasodilatory actions, may be involved. Ursodeoxycholic acid, a hydrophilic bile acid, could potentially decrease systemic arterial vasodilatation, possibly due to its antioxidant effects, and improve sodium handling in cirrhosis. The effects of ursodeoxycholic acid on systemic, renal and forearm haemodynamics, liver function and renal sodium handling were assessed in vasodilated cirrhotic patients with refractory ascites treated with a transjugular intrahepatic porto-systemic shunt (TIPS). Eight cirrhotic patients with refractory ascites without TIPS placement served as controls for the sodium handling effects of ursodeoxycholic acid. From 1 month post TIPS, seven patients were studied before, after 1 month of treatment with ursodeoxycholic acid (15 mg·day-1·kg-1) and at 1 month follow-up. Lipid peroxidation products were used as indices of its antioxidant effects. Ursodeoxycholic acid caused a significant reduction in sodium excretion in both groups (P< 0.05). This, in the post-TIPS patients (urinary sodium excretion: 35±8 mmol/day at 1 month versus 93±21 mmol/day at baseline, P< 0.05), was due to a significant increase in sodium reabsorption proximal to the distal tubule (P< 0.05), without any significant changes in systemic, renal or forearm haemodynamics, or in liver function. No significant change in lipid peroxidation products was observed. We conclude that: (i) in cirrhotic patients with refractory ascites, ursodeoxycholic acid causes sodium retention, (ii) the abnormality in sodium handling in the post-TIPS cirrhotic patients appears to be the result of a direct effect on the proximal nephron, suggesting that factors other than systemic vasodilatation also contribute to sodium retention in cirrhosis, (iii) caution should be exercised in administering ursodeoxycholic acid in cirrhotic patients with ascites.

scholarly journals Adenosine and renal sodium handling: direct natriuresis and renal nerve-mediated antinatriuresis.

1995 ◽  
Vol 6 (5) ◽  
pp. 1491-1497
Author(s):  
R Fransen ◽  
H A Koomans
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Distal Tubule ◽  
Systemic Circulation ◽  
Renal Nerves ◽  
Sodium Reabsorption ◽  
Left Renal Artery ◽  
Sodium Retention ◽  
Renal Nerve ◽  
Sodium Handling

Adenosine infusion is associated with natriuresis as well as antinatriuresis. The physiologic significance of these opposite effects is unknown but may have to do with different conditions of ischemia, in which adenosine accumulates. These effects were characterized in the rat. First, intrarenal and systemic infusions within one animal were performed. Infusing 10 micrograms/min into the left renal artery increased sodium by approximately 50%; however, the subsequent infusion of 50 micrograms/min into the thoracic aorta decreased sodium excretion by approximately 60%, in association with a small reduction of blood pressure. Second, to explore the effect of intrarenal adenosine in tubular sodium handling, free-flow micropuncture experiments were performed. The intrarenal infusion of 10 micrograms/min again caused sodium excretion, but no change in GFR, volume, and sodium deliveries up to the early distal tubule was found. Apparently, the direct effect of adenosine in the kidney is sodium excretion, by a tubular action beyond the early distal tubule. Third, to further characterize the indirect effect, which apparently is sodium retention, adenosine was infused systemically at low rates, in order to avoid a decrease in blood pressure. A 25 micrograms/min infusion again caused sodium retention, in the absence of a fall in blood pressure. After acute left renal denervation, the antinatriuretic effect disappeared in the denervated kidney but remained in the right kidney. These data suggest that increased intrarenal adenosine suppresses sodium reabsorption at some distal nephron site, appropriately decreasing the workload of the kidney. On the other hand, systemic adenosine stimulates sodium reabsorption, an effect that is appropriate to improve systemic circulation and depends on the renal nerves.

Effects of ursodeoxycholic acid on systemic, renal and forearm haemodynamics and sodium homoeostasis in cirrhotic patients with refractory ascites

1999 ◽  
Vol 96 (5) ◽  
pp. 467 ◽  
Author(s):  
Florence WONG ◽  
Arieh BOMZON ◽  
Johane ALLARD ◽  
Peter LIU ◽  
Laurence BLENDIS
Keyword(s):  
Ursodeoxycholic Acid ◽  
Refractory Ascites ◽  
Cirrhotic Patients

Synbiotic-associated improvement in liver function in cirrhotic patients: Relation to changes in circulating cytokine messenger RNA and protein levels

2007 ◽  
Vol 19 (1) ◽  
Author(s):  
Stephen M. Riordan ◽  
Narelle A. Skinner ◽  
Christopher J. Mciver ◽  
Qing Liu ◽  
Stig Bengmark ◽  
...  
Keyword(s):  
Liver Function ◽  
Messenger Rna ◽  
Protein Levels ◽  
Cirrhotic Patients

scholarly journals PSVII-17 Program Chair Poster Pick: Reproductive function of cows depending on lipid metabolism

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 293-294
Author(s):  
Murat Baymishev ◽  
Sergey Eremin ◽  
Kirill Plemyashov ◽  
Khamidulla Baymishev ◽  
Igor Konopel’tsev ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Live Weight ◽  
Reproductive Function ◽  
Serum Levels ◽  
Total Serum ◽  
Dry Period ◽  
Lipid Peroxidation Products ◽  
Synthetic Function ◽  
The Difference ◽  
Oxidized Products

Abstract The aim of the study was to determine the etiopathogenesis of reproductive dysfunction in highly productive cows. Studies were conducted on cows of black-motley breed, aged 3–5 lactations, with a live weight of 480–520 kg. Cows were divided into two groups. The first group included 20 cows effective inseminated after the first insemination. The second group included 17 cows that did not fertilize after the first insemination. Blood samples (n = 253) were taken from 4–7; 14–17; 24–34; 35–50; 88–95; 195–210 days of pregnancy; during the beginning of dry period (DP); 1–4 days before calving and on the first day after calving. The content of total serum lipids in pregnant animals was 15.8% higher compared to unfertilized animals. In non-pregnant cows, a decrease in free cholesterol (by 28.65%), especially in its ether-bound fraction (14.91%), indicates a lower synthetic function of the liver, which is confirmed by the low serum levels of vitamins A and E (a difference of 11.3 and 23.65%). The DP was characterized by a significant increase in the products of lipid peroxidation - malondialdehyde by 12–17%, diene and triene conjugates - by 10–15 and 8–15%, respectively, and 1–4 days before calving in cows, which subsequently had a pathological calving, in particular - retention of placenta (5 cows), were characterized by an increased content in the blood plasma of lipid peroxidation products. Thus, the difference in the number of dienes, trienes, and malondialdehyde products was 14.0, 12.0, and 23.5%, compared with animals without obstetric pathology. On the first day after calving, this difference increased even more. Cows with retention of placenta had a significantly higher level of lipid peroxidation products and were characterized by a predominance of oxidized products over the antiradical thiol disulfide and ascorbate systems restored in the antioxidant balance.

scholarly journals Laparoscopic versus Open Liver Resection: Differences in Intraoperative and Early Postoperative Outcome among Cirrhotic Patients with Hepatocellular Carcinoma—A Retrospective Observational Study

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Siniscalchi ◽  
Giorgio Ercolani ◽  
Giulia Tarozzi ◽  
Lorenzo Gamberini ◽  
Lucia Cipolat ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Liver Function ◽  
Hospital Stay ◽  
Perioperative Complications ◽  
Laparoscopic Approach ◽  
Postoperative Outcome ◽  
Laparoscopic Technique ◽  
Surgical Trauma ◽  
Cirrhotic Patients

Introduction. Laparoscopic liver resection is considered risky in cirrhotic patients, even if minor surgical trauma of laparoscopy could be useful to prevent deterioration of a compromised liver function. This study aimed to identify the differences in terms of perioperative complications and early outcome in cirrhotic patients undergoing minor hepatic resection for hepatocellular carcinoma with open or laparoscopic technique. Methods. In this retrospective study, 156 cirrhotic patients undergoing liver resection for hepatocellular carcinoma were divided into two groups according to type of surgical approach: laparoscopy (LS group: 23 patients) or laparotomy (LT group: 133 patients). Perioperative data, mortality, and length of hospital stay were recorded. Results. Groups were matched for type of resection, median number of nodules, and median diameter of largest lesions. Groups were also homogeneous for preoperative liver and renal function tests. Intraoperative haemoglobin decrease and transfusions of red blood cells and fresh frozen plasma were significantly lower in LS group. MELD score lasted stable after laparoscopic resection, while it increased in laparotomic group. Postoperative liver and renal failure and mortality were all lower in LS group. Conclusions. Lower morbidity and mortality, maintenance of liver function, and shorter hospital stay suggest the safety and benefit of laparoscopic approach.

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