{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:24:52Z","timestamp":1791894292452,"version":"4.3.4"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":6240,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Fondo de Investigaciones Sanitarias","award":["FIS\/97\/2073"],"award-info":[{"award-number":["FIS\/97\/2073"]}]},{"DOI":"10.13039\/501100006527","name":"Direcci\u00f3n General de Investigaci\u00f3n Cient\u00edfica y T\u00e9cnica","doi-asserted-by":"crossref","award":["SAF96-0131"],"award-info":[{"award-number":["SAF96-0131"]}],"id":[{"id":"10.13039\/501100006527","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Dr. Guevara was supported by a grant from the Fundaci\u00f3 Cl\u00ednic per la Recerca Biom\u00e8dica. Dr. Sort was supported by a fellowship grant from the Hospital Cl\u00ednic of Barcelona"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1998,8]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Little information exists on the effects of transjugular intrahepatic portosystemic shunts (TIPS) in the management of cirrhotic patients with hepatorenal syndrome (HRS). The current study was aimed to prospectively evaluate the effects of TIPS on renal function and vasoactive systems in patients with type I HRS. Glomerular filtration rate (GFR) (inulin clearance), renal plasma flow (RPF) (para-aminohippurate clearance), plasma renin activity (PRA), aldosterone (ALDO), norepinephrine (NE), and endothelin (ET) were determined in baseline conditions and at different time intervals after TIPS in 7 patients with type I HRS. TIPS induced a marked reduction of portal pressure gradient (PPG) (20 \u00b1 1 to 10 \u00b1 1 mm Hg; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05). Renal function improved in 6 of the 7 patients. Serum creatinine and blood urea nitrogen (BUN) decreased from 5 \u00b1 0.8 and 109 \u00b1 7 to 1.8 \u00b1 0.4 mg\/dL and 56 \u00b1 11 mg\/dL, respectively (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05 for both), and GFR and RPF increased from 9 \u00b1 4 and 103 \u00b1 33 to 27 \u00b1 7 mL\/min and 233 \u00b1 40 mL\/min, respectively (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05 for both), 30 days after TIPS. These beneficial effects on renal function were associated with a significant (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .05) reduction of PRA (18 \u00b1 5 to 3 \u00b1 1 ng\/mL \u00b7 h), ALDO (279 \u00b1 58 to 99 \u00b1 56 ng\/dL), and NE (1,257 \u00b1 187 to 612 \u00b1 197 pg\/mL). ET did not change significantly (28 \u00b1 8 to 27 \u00b1 11 pg\/mL). Mean survival was 4.7 \u00b1 2 months (0.3-17 months). Three patients remained alive more than 3 months after TIPS insertion. In conclusion, TIPS improves renal function and reduces the activity of the renin-angiotensin and sympathetic nervous systems in cirrhotic patients with type I HRS. Nevertheless, the efficacy of TIPS in the management of these patients should be confirmed in controlled investigations.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510280219","type":"journal-article","created":{"date-parts":[[2004,7,27]],"date-time":"2004-07-27T23:57:44Z","timestamp":1090972664000},"page":"416-422","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":330,"title":["Transjugular intrahepatic portosystemic shunt in hepatorenal syndrome: Effects on renal function and vasoactive systems"],"prefix":"10.1097","volume":"28","author":[{"given":"M\u00f3nica","family":"Guevara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Gin\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Bandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Gilabert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"Sort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wladimiro","family":"Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Garcia-Pag\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Arroyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Rod\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.510280219-BIB1|cit1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1038\/ki.1993.105","article-title":"Hepatorenal syndrome","volume":"43","author":"Levy","year":"1993","journal-title":"Kidney Int"},{"key":"10.1002\/hep.510280219-BIB2|cit2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1055\/s-2007-1007294","article-title":"Peripheral arterial vasodilation: determinant of functional spectrum of 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