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Elevated intra-abdominal pressure increases plasma renin activity and aldosterone levels
G L Bloomfield1, C R Blocher, I F Fakhry
1Department of General/Trauma Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0519, USA.
The Journal of Trauma
|June 1, 1997
Summary
Elevated intra-abdominal pressure impairs kidney function and activates the renin-angiotensin-aldosterone system. Volume expansion and decompression can reverse these harmful effects on renal function.
Area of Science:
- Physiology
- Nephrology
- Endocrinology
Background:
- Elevated intra-abdominal pressure (IAP) is a critical condition affecting multiple organ systems.
- The impact of IAP on renal function and the hormonal systems regulating blood pressure and fluid balance requires further elucidation.
Purpose of the Study:
- To investigate the effects of acutely elevated intra-abdominal pressure on renal function.
- To examine the influence of elevated intra-abdominal pressure on the renin-angiotensin-aldosterone system.
Main Methods:
- Anesthetized swine underwent controlled increases in intra-abdominal pressure using instilled fluid.
- Hemodynamic parameters, renal venous pressure, and urine output were monitored.
- Plasma levels of renin, aldosterone, and atrial natriuretic factor were measured.
Main Results:
- Elevated intra-abdominal pressure significantly increased renal venous pressure and decreased cardiac index and urine output.
- Plasma renin and aldosterone levels rose significantly with elevated intra-abdominal pressure.
- Volume expansion and abdominal decompression reversed the negative effects on renal function and hormonal levels.
Conclusions:
- Acutely elevated intra-abdominal pressure impairs renal function and stimulates the renin-angiotensin-aldosterone system.
- Combined intravascular volume expansion and abdominal decompression effectively mitigate the adverse effects of elevated intra-abdominal pressure on renal function and hormonal balance.