Mechanisms of changes in renal handling of sodium following transjugular intrahepatic portal systemic stent-shunt (TIPSS)

Ravij Jalan, Doris N. Redhead, Huw W. Thomas, Neil Henderson, Kevin Orourke, John F. Dillon, Brent C. Williams, Peter C. Hayes

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    Abstract

    Background and aims: Transjugular intrahepatic portosystemic stent-shunt (TIPSS) reduces the portal pressure gradient and leads to better control of ascites. The aim of this study was to evaluate (1) changes in renal handling of sodium following TIPSS and (2) the mechanism of these changes. Design: Prospective study. Setting: Tertiary referral centre for liver diseases. Methods: Eighteen patients with ascites undergoing TIPSS for recurrent variceal haemorrhage (16) (3 or more hospital admissions because of variceal haemorrhage whilst being treated endoscopically) or refractory ascites (2) were studied. Urinary sodium (UNa), creatinine clearance (CrCl), plasma renin activity (PRA), atrial natriuretic peptide (ANP), cyclic guanosine monophosphate (cGMP), Angiotensin II (All) and lithium clearance (LiCl) were measured before and 3 months after TIPSS when portography was performed and the portal pressure gradient (PPC) also measured. All patients were haemodynamically stable and had received no diuretics for at least 1 week before blood sampling. Results: Improvement in ascites was achieved in ail patients in whom TIPSS was inserted successfully (reduction in PPC to
    Original languageEnglish
    Pages (from-to)1111-1116
    Number of pages6
    JournalEuropean Journal of Gastroenterology & Hepatology
    Volume8
    Issue number11
    Publication statusPublished - 1996

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