IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 2013;6(11):2523-2528

Original Article
Hepatorenal syndrome: insights into the mechanisms of intra-abdominal hypertension

Yizhong Chang, Xiaolong Qi, Zhiwei Li, Fei Wang, Shenglan Wang, Zhaojie Zhang, Chaohui Xiao, Tongling Ding, Changqing Yang

Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Division of
Hepatobiliary Surgery, 302 Hospital of Chinese People’s Liberation Army, Beijing 100039, China. Equal contributors.

Received August 15, 2013; Accepted September 17, 2013; Epub October 15, 2013; Published November 1, 2013

Abstract: Objective: Hepatorenal syndrome is one of the serious complications of cirrhosis and closely associated with the increasing intra-
abdominal pressure (IAP). The study aims to explore the potential mechanism of intra-abdominal hypertension in the development of
hepatorenal syndrome in mouse models. Methods: Eighty male mice were randomly divided into model group (subcutaneous injection of
carbon tetrachloride) and control group (subcutaneous injection of olive oil). After 12 weeks, parts of the mice were sacrificed and liver
histopathology was detected. Then, albumin (30 g/L) and normal saline were separately injected into the peritoneal cavity of mice to induce the
different IAP levels (0, 5, 10 and 20cmH2O). Blood urea nitrogen, serum creatinine and renal histopathology were examined 24 hours later.
Results: Blood urea nitrogen and serum creatinine levels were statistically significant high in the group of IAP= 10 and 20cmH2O as compared
with the IAP= 0cmH2O. From results of renal histopathology, the constrictive renal tubular lumen and inflammatory infiltration in the interstitial
were observed in groups of IAP= 5 and 10cmH2O. Besides, the formed casts and hyperemia in the renal interstitial could be detected in group
of IAP= 20cmH2O. The cellular swelling and edema of renal tubular epithelial cells were found in model group simultaneously. Conclusions:
Our study suggested that intra-abdominal hypertension was a significant pathological mechanism and a potential independent risk factor of
hepatorenal syndrome. (IJCEP1308043).

Keywords: Intra-abdominal hypertension, hepatorenal syndrome, abdominal compartment syndrome, cirrhosis

Address correspondence to: Dr. Changqing Yang, Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University School of
Medicine, Shanghai 200065, China. Tel: +86-21-66111076; Fax: +86-21-66111604; E-mail: cqyang@tongji.edu.cn