NEUROHUMORAL SYSTEMS IN PATIENTS WITH CIRRHOSIS

In order to evaluate the activation of the sympathetic nervous and ren in-angiotensin systems and antidiuretic hormone release in the setting of chronic liver disease, we studied 30 patients with cirrhosis who p resented normal renal function. The cirrhotic patients were divided in to two groups according to Child's score: 20 were Child A and 10 Child B. The control group consisted of 10 normal subjects. Blood samples w ere collected for determination of norepinephrine (NE), dopamine (DA), angiotensin I and II (AI and AII), and antidiuretic hormone (ADH), us ing the method of high-performance liquid chromatography (HPLC). No si gnificant differences (p < 0.05) were found in the plasma levels of NE , DA, AI, and AII between the cirrhotic patients and the controls, alt hough the absolute values observed in both groups of cirrhotics were c learly higher than in controls. The ADH levels were higher in Child B in comparison to Child A patients and controls, though this difference was not significant as well. Our results suggest a hormonal activatio n in cirrhotic patients, even in the early stages of hepatic disease ( without ascites). We also noted an increase in ADH levels in Child B p atients in relation to Child A and controls, although there was no dif ference in osmolality, suggesting a nonosmotic ADH release.