Effects of renal and hepatic venous congestion on renal function in the presence of low and normal cardiac output in dogs.

Abstract

We investigated the effect of acute renal vein and hepatic vein hypertension induced by partial balloon-occlusion of the abdominal inferior vena cava (AIVC-O) and the thoracic inferior vena cava (TIVC-O) on systemic and renal hemodynamics and renal function in 13 dogs anesthetized with pentobarbital. When a renal vein pressure of 13 cm H2O was induced by AIVC-O, cardiac output, stroke volume, central venous pressure, renal blood flow, and renal function (GFR, free water clearance, osmolar clearance, urine output, urinary sodium excretion, fractional sodium excretion) decreased significantly. When systemic hemodynamics were restored to control values by transfusion of autologous blood (mean of 9 ml/kg body weight) while renal vein pressure was kept elevated, renal function also was restored. A hepatic venous pressure of 13 cm H2O then was induced by TIVC-O. The effects on systemic hemodynamics and renal function were very similar to those observed during AIVC-O. When systemic hemodynamics were restored to control values by transfusion (mean of 9 ml/kg), while hepatic venous hypertension was maintained by TIVC-O, renal function also was restored. Despite significant changes in natriuresis and diuresis, intrarenal blood flow distribution, as determined by the radioactive microsphere technique, remained essentially unchanged throughout. We conclude that renal and hepatic congestion induced by partial AIVC-O and TIVC-O do not, per se, alter renal function significantly.