hepatic and biliary disorders
Systemic Abnormalities in Liver Disease
Circulatory Abnormalities
Hypotension in advanced liver failure may contribute to renal dysfunction. The pathogenesis of the hyperdynamic circulation (increased cardiac output and heart rate) and hypotension that develop in advanced liver failure or Cirrhosis is poorly understood but is in part a compensatory mechanism for extensive peripheral splanchnic vasodilation. Factors that may contribute in cirrhosis may include altered sympathetic tone, production of nitric oxide and other endogenous vasodilators, and enhanced activity of humoral factors (eg, For specific disorders of hepatic circulation (eg, Budd-Chiari Syndrome ), see 