Enhanced renal sympathetic tone in liver cirrhosis: evaluation by intrarenal administration of dihydroergocristine.

Abstract

Mean renal blood flow (MRBF), cortical blood flow (CBF), glomerular filtration rate (GFR), heart rate, arterial blood pressure, Na+ and K+ excretion were determined before and 10 min after intrarenal administration of dihydroergocristine (0.017 mg/kg b.w.) in 13 patients suffering from liver cirrhosis. Cardiac output was also determined in 6 patients. Baseline values of MRBF and CBF were significantly lower in cirrhotics than in the 14 control subjects. Following intrarenal administration of the drug, renal hemodynamic parameters increased significantly, while GFR decreased. Systemic hemodynamic parameters, diuresis, Na+ and K+ excretions were unchanged. These data show that dihydroergocristine has a renal vasodilator effect, probably mediated by alpha-adrenergic blockade. The effect probably is prevalent at the postglomerular site, where the increase in vascular resistance is greatest. The effect of the drug suggests that patients with liver cirrhosis have enhanced renal sympathetic activity which is, at least in part, responsible for the renal vasoconstriction.