3 cases with intractable ascites improved by the peritoneovenous shunt

Study on plasma α-human atrial natriuretic peptide before and after the peritoneovenous shunt

Abstract

Plasma levels of α-human atrial natriuretic peptide (α-hANP), renin activity and aldosterone, central venous pressure and urine volume were measured before and after the peritoneovenous shunt implantation in 3 cases of decompensated cirrhotic patients with intractable ascites.
After the shunt implantation, ascites decreased immediately in amount. Plasma levels of α-hANP in all cases before the implantation were above the upper normal limit. The α-hANP levels increased significantly as compared with the preoperative levels in the early stage of post-implantation. However, the α-hANP levels showed to be lower than the preoperative levels in the late stage of the post-implantation. These data suggest that the elevation of plasma α-hANP levels in cirrhotic patients with intractable ascites are related to the decrease of renal blood flow and increased reabsorption of sodium and water.