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Functional Renal Failure in Cirrhosis: Recovery After Portacaval Shunt

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▸Requests for reprints should be addressed to Edward T. Schroeder, M.D., Department of Medicine, State University Hospital, Syracuse, N. Y. 13210

Syracuse, New York

Ann Intern Med. 1970;72(6):923-928. doi:10.7326/0003-4819-72-6-923
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A 42-year-old woman with alcoholic cirrhosis spontaneously developed severe and prolonged oliguric functional renal failure. After 14 weeks of oliguria, unimproved by plasma expansion, and progressive uremia requiring repeated peritoneal dialysis, a portacaval shunt was constructed to improve renal perfusion. Improvement in renal function began immediately after surgery, and creatinine clearance rose from 8 to 75 ml/min. Presurgical abnormalities of blood pressure, hyperaldosteronism, renal dilution mechanisms, and plasma renin returned to normal or near normal after surgery. Recovery of renal function may have been a result of altered hemodynamics associated with construction of the portacaval shunt.





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