{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:13:33Z","timestamp":1777911213273,"version":"3.51.4"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2008,12,2]],"date-time":"2008-12-02T00:00:00Z","timestamp":1228176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2008,12,2]],"date-time":"2008-12-02T00:00:00Z","timestamp":1228176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"abstract":"<jats:p>The charts of 30 consecutive patients who underwent implantation of a LeVeen type of peritoneal-venous (P-V) shunt were reviewed. 29 patients had Laennec\u2019s cirrhosis and ascites refractory to medical therapy. Of these, 7 or 24% had hepatorenal syndrome (HRS), i.e. creatininemia and azotemia, a low urinary sodium (UNa), and no other apparent cause for renal failure. In these patients with plasma creatinine (pCr) &gt; 1.6 mg\/dl and BUN &gt; 30 mg\/dl and UNa &lt; 10 mEq\/1, the P-V shunt s ingificantly improved all 3 measures of renal function: pCr decreased from 4.3 to 2.7 mg\/dl (p &lt; 0.025) BUN decreased from 79 to 38 mg\/dl (p &lt; 0.025) and UNa increased to 70 mEq\/1. 4 of these patients are still alive, a mean of 418 days after being shunted (preshunt BUN = 60 mg\/dl). 3 patients died a mean of 81.7 days after shunt implantation (preshunt BUN = 83 mg\/dl), none from renal failure. Of the 29 patients with refractory ascites, + \/ \u2013 HRS, the implantation of this shunt was associated with a significant increase in renal sodium clearance (CNa) and fraction of the filtered sodium being excreted CNa\/Ccr. The CNa\/Ccr increased after shunting in patients studied while off diuretics from 0.21 to 1.45% (p &lt; 0.025). The avid renal salt adsorption characteristic of refractory ascites and HRS appears to have been reversed. The P-V shunt appears to be beneficial therapy, especially in preterminal HRS, and appears to function in a physiologic manner, by decreasing the renal reabsorption of sodium and water.<\/jats:p>","DOI":"10.1159\/000181640","type":"journal-article","created":{"date-parts":[[2008,12,3]],"date-time":"2008-12-03T16:39:41Z","timestamp":1228322381000},"page":"228-232","source":"Crossref","is-referenced-by-count":20,"title":["The \u2018Hepatorenal\u2019 Syndrome and Refractory Ascites"],"prefix":"10.1159","author":[{"given":"Michael J.","family":"Kinney","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Wapnick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saul","family":"Grosberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Le Veen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2008,12,2]]},"container-title":["Nephron"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/181640","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000181640","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T15:18:29Z","timestamp":1777648709000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000181640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,12,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/000181640","archive":["Portico"],"relation":{},"ISSN":["1660-8151","2235-3186"],"issn-type":[{"value":"1660-8151","type":"print"},{"value":"2235-3186","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,12,2]]}}}