Hepatorenal syndrome: insights into the mechanisms of intra-abdominal hypertension

Int J Clin Exp Pathol. 2013 Oct 15;6(11):2523-8. eCollection 2013.

Abstract

Objective: Hepatorenal syndrome is one of the serious complications of cirrhosis and closely associated with the increasing intra-abdominal pressure (IAP). The study aims to explore the potential mechanism of intra-abdominal hypertension in the development of hepatorenal syndrome in mouse models.

Methods: Eighty male mice were randomly divided into model group (subcutaneous injection of carbon tetrachloride) and control group (subcutaneous injection of olive oil). After 12 weeks, parts of the mice were sacrificed and liver histopathology was detected. Then, albumin (30 g/L) and normal saline were separately injected into the peritoneal cavity of mice to induce the different IAP levels (0, 5, 10 and 20cmH2O). Blood urea nitrogen, serum creatinine and renal histopathology were examined 24 hours later.

Results: Blood urea nitrogen and serum creatinine levels were statistically significant high in the group of IAP= 10 and 20cmH2O as compared with the IAP= 0cmH2O. From results of renal histopathology, the constrictive renal tubular lumen and inflammatory infiltration in the interstitial were observed in groups of IAP= 5 and 10cmH2O. Besides, the formed casts and hyperemia in the renal interstitial could be detected in group of IAP= 20cmH2O. The cellular swelling and edema of renal tubular epithelial cells were found in model group simultaneously.

Conclusions: Our study suggested that intra-abdominal hypertension was a significant pathological mechanism and a potential independent risk factor of hepatorenal syndrome.

Keywords: Intra-abdominal hypertension; abdominal compartment syndrome; cirrhosis; hepatorenal syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albumins
  • Animals
  • Biomarkers / blood
  • Blood Urea Nitrogen
  • Carbon Tetrachloride
  • Creatinine / blood
  • Hepatorenal Syndrome / blood
  • Hepatorenal Syndrome / etiology*
  • Hepatorenal Syndrome / pathology
  • Intra-Abdominal Hypertension / blood
  • Intra-Abdominal Hypertension / chemically induced
  • Intra-Abdominal Hypertension / complications*
  • Intra-Abdominal Hypertension / pathology
  • Kidney / pathology
  • Liver / pathology
  • Liver Cirrhosis, Experimental / chemically induced
  • Liver Cirrhosis, Experimental / complications
  • Male
  • Mice
  • Mice, Inbred ICR
  • Pressure
  • Risk Factors
  • Sodium Chloride

Substances

  • Albumins
  • Biomarkers
  • Sodium Chloride
  • Creatinine
  • Carbon Tetrachloride