The kidney in cirrhosis with portal hypertension

Ascites, dilutional hyponatremia and hepatorenal syndrome are three clinical manifestations of the same physiopathological disorder: cirrhotic portal hypertension, hyperproduction of nitric oxide, arterial vasodilation with reduction of efficient arterial volume, which have as consequences renal vasoconstriction, sympathetic stimulation, the stimulation of renin–angiotensin–aldosteron system and of vasopressin secretion. In dilutional hyponatremia, the selective receptor V2 (vasopressin 1) antagonists may be efficient according to Spanish and American specialists and also according to personal experience [6,9]. Abbreviations:Ly = lymphatic hyperproduction,Alb = hypoalbuminaemia, NO = nitric oxide,Sy = sympathetic (nervous) system,HRS = hepatorenal syndrome