Kidney, lower limb and whole-body uptake and release of catecholamines in alcoholic liver disease

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Abstract
Regional (kidney, lower limb) and whole‐body kinetics of endogenous noradrenaline (NA) and tritium‐labelled L‐noradrenaline (3H‐NA) were determined in patients with alcoholic liver disease (one alcoholic hepatitis, 12 cirrhosis) and in control subjects (n= 6) in order to get information on the sympatho‐adrenal system in liver disease. Arterial NA was significantly elevated in ascitic patients (median 2·5 nmol/1, n = 9, PPPP3H‐NA (0·34 vs. 0·32NS and 0·34 vs. 0·37 NS, respectively). Whole‐body clearance of 3H‐N A was not significantly different in cirrhotics and controls (median 0·89 vs. 0·91 1/min·m2), indicating that the raised NA in decompensated cirrhosis reflects enhanced sympatho‐adrenal activity rather than decreased metabolism of this amine. Our results do not point towards a uniform sympatho‐adrenal overactivity in decompensated cirrhosis, but rather indicate regional differences with different order of NA spillover. The renal sympathetic overactivity, as indicated by the increased renal NA overflow, is likely to be important to the decreased renal perfusion and increased saltwater retention characteristic of this clinical condition.