Effects of lumbar sympathetic block on kidney function in cirrhotic patients with hepatorenal syndrome

• Published in: Journal of hepatology Vol. 5; no. 2; pp. 167 - 173
• Main Authors: Solis-Herruzo, J.A., Duran, A., Favela, V., Castellano, G., Madrid, J.L., Muñoz-Yagüe, M.T., Morillas, J.D., Estenoz, J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.10.1987; Elsevier
• Subjects: Adrenergic Fibers - drug effects; Adrenergic Fibers - physiology; Aged; Autonomic Nerve Block; Biological and medical sciences; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hepatorenal Syndrome - etiology; Hepatorenal Syndrome - physiopathology; Hepatorenal Syndrome - therapy; Humans; Kidney - innervation; Kidney - physiopathology; Kidney Diseases - therapy; Kidney Function Tests; Liver Cirrhosis - complications; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Human; Cirrhosis; Liver failure; Liver; Local anesthesia; Renal failure; Blocking; Digestive diseases; Sympathic nervous system
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(87)80569-X

We studied the effects of unilateral lumbar sympathetic block on kidney function in eight patients with cirrhosis and hepatorenal syndrome. In five patients with basal glomerular filtration rate (GFR) below 25 ml/min, sympathetic block induced a significant increase in GFR, osmolal clearance, urinary sodium excretion, fractional excretion of filtered sodium (FE Na) and effective renal plasma flow (ERPF) and a decrease in plasma renin activity. In the three patients with basal GFR greater than 25 ml/min, sympathetic block produced no significant change in renal function. We conclude that sympathetic block might improve renal function in cirrhotics with hepatorenal syndrome, particularly those with more impaired GFR.