Renin angiotensin system in liver diseases: Friend or foe?

Figure 1 Hemodynamic changes in early and advanced stages of liver cirrhosis. The early phase of cirrhosis is characterized by elevated cardiac output and low systemic vascular resistance without changes in the circulating levels of renin angiotensin system (RAS) components and antidiuretic hormone (ADH). However, as the disease progresses, activation of the circulating RAS and of the sympathetic nervous system and secretion of the antidiuretic hormone occur in response to persistent arterial hypotension. Legend: Ang II: Angiotensin II; Ang-(1-7): Angiotensin (1-7); SNS: Sympathetic nervous system; SVR: Systemic vascular resistance.