Hepatorenal Syndrome and Efficiency of Aldosterone Receptor Blockade on Hepatorenal System and Systemic Hemodynamics in Dogs with Experimentally Induced Hepatic Cirrhosis

Authors: REMZİ GÖNÜL, UTKU BAKIREL, ABDULLAH KAYAR, YÜCEL MERAL, MEHMET ERMAN OR, GÜLBİN ŞENNAZLI, AYDIN GÜREL, EMİNE AKDENİZLİ

Abstract: In this study, the clinical signs of hepatorenal syndrome that occurs during hepatic cirrhosis were investigated and a variety of diagnosis and therapy methods were investigated in the experimentally ligated bile ducts of dogs. The test group with ligated bile ducts (n = 14) and the sham operated control group (n = 14) were divided into 2 sub groups and administered a derivative of spironalactone (Aldoctan® tablet), an antagonist of the aldosteron receptor, at 1.5 mg/kg daily for 5 weeks. Hepatorenal changes and the systemic effects of the drug were determined by comparing the control and test groups during the decompensation period, which occurred at 4-6 weeks of hepatic cirrhosis. At the end of the study the macroscopic and microscopic changes in the livers of the dogs in Group 1 were determined. It was determined that the serum levels of AST, ALT, T. biluribin, D. biluribin, ALP and GGT significantly increased (P < 0.001-0.01) whereas the serum levels of T. protein and albumin decreased in all the dogs. It was observed that in all groups the serum levels of aldosterone, sodium and potassium were within normal limits. Urine biluribin and urobilinogen levels were quantitatively determined. Test results and examinations of the dogs showed that the systemic hemodynamics and heart rate were the same in all groups. In contrast, it was determined that the glomerular filtration rate was decreased especially in non-aldactonized cirrhotic dogs. In the ultrasonographic examination, hepatocardiac evaluation revealed that there were no significant cardiac changes. At the end of the study, it was determined that aldosterone receptor antagonists prevent decreases in the glomerular filtration rate even in the early stages, and thus can be useful to prevent the edema and ascites in cirrhotic dogs.

Keywords: Dog, liver, cirrhosis, bile duct, hepatorenal syndrome, cystatin C, hemodynamic

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