Renal Effects of Acute Expansion of Plasma Volume in Cirrhosis

Abstract

GLOMERULAR filtration rate and renal plasma flow may be sharply reduced in patients with advanced cirrhosis.^{1 2 3 4} Reduction of glomerular filtration and deficient urine volume in these patients is probably related to decreased "effective" plasma volume secondary to persistent sequestration of blood in the splanchnic bed. The term "effective" plasma volume should be differentiated from "total" plasma volume, which may be increased in these patients.^5,6 Expansion of plasma volume in patients with cirrhosis can be achieved with the reinfusion of ascites⁷ or albumin alone.⁸ Such treatments have been reported to increase urine volume, sodium excretion and glomerular filtration rate.^{7 8 9 10 11 12} The . . .