JAMA. 1963;183(3):204. doi:10.1001/jama.1963.03700030080018.
Text Size: A A A
Published online

Laennec's cirrhosis complicated by renal failure is one of the conditions sometimes included in the term "hepatorenal syndrome." Papper1 reported that although significant hypotension is not requisite, it is a frequent finding when oliguria appears in the cirrhotic patient. This investigator noted also that the profound changes in renal function need not be associated with anatomical renal abnormalities. These observations and other recent reports suggest that impaired renal perfusion rather than damage to the renal parenchyma is the fundamental factor in the production of oliguria and nitrogen retention. The elevated urinary concentration is in accord with such a theory; urine of high specific gravity is usually present in spite of renal failure. Moreover, renal failure may appear in cirrhotic patients after minimal gastrointestinal bleeding or after abdominal peracentesis, possibly as a consequence of a decrease in effective blood volume. Some of these patients respond to pressor drugs with an


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.