RESUMO
Objective To explore the influence of increased intraabdominal pressure caused by ascites on renal function.Methods (1)The renal function , intraabdomanal pressure and renal artery resistence index before and after the operation were compared in 6 patients with refractory ascites treated by peritonovenous shunts. (2)The changes of renal arterial resistence , outflow of renal vein , cardiac output ,serum angiotensin and aldosterone were determined and compared under the condition of compression and decompression of abdominal cavity with raised intraabdominal pressure in 6 dog models. Results In 6 patients,asites disappeared after the shunts operation, intraabdominal pressure decreased from (25.2?6.6)cmH 2O to (6.4?3.0)cmH 2O,BUN decresed from (12.5?3.6)mmol/L to (8.2?2.6)mmol/L,renal arterial resistence decreased obviously.In the dog models,the cardiac output , adosterone and angiotension were no sigmificant differece in all the time,but renal arterial restence increased and venous outflow decreased significantly.However all the changes restored to normal levels after decompressions. Conclusion Elevated intraabdominal pressure by ascites can decreases renal blood perfusion and its function. peritonovenous shunt can decrease intraabdominal pressure effectively and improve renal function.
