Much progress has been made in the recognition of factors involved in the pathogenesis
of the abnormal regulation of extracellular fluid volume in cirrhosis. It is now well
established that cirrhosis induces modifications in the activity of several systemic
vasoactive factors which then play a major role in the development of renal dysfunction
and the formation of ascites and edema. It is also evident that intrarenal factors
participate in the pathogenesis of these abnormalities. Nevertheless, the available
information is still limited. The link between the diseased liver and the disturbances
in the vasoactive systems is not completely known but much evidence suggests that
it consists of a circulatory dysfunction that affects mainly the arterial circulation
and is characterized by an inability to maintain an effective arterial blood volume
within normal limits. Research on the mechanisms of this circulatory dysfunction may
yield clues that will help in the design of more pathophysiologically oriented therapeutic
approaches to the management of ascites.
edema - renal dysfunction - vasoactive systems
