Kidney disease in patients with chronic liver disease: Does sex matter?

Figure 2 Hepatorenal physiology: A simplified perspective. Hepatorenal physiology includes a cascade of multi-systemic effects that initiate with portal hypertension. Portal hypertension is associated with increased inflammation, reduced effective circulating volume, systemic vascular resistance, altered cardiac hemodynamics, and gut bacterial translocation. Subsequent increased circulation of vasodilators including nitric oxide and prostaglandins, and activation of the renin-angiotensin-aldosterone system result in dysregulated renal vasoconstriction and decreased renal perfusion. Note: The cascade of pathophysiology in hepatorenal syndrome is complex and understanding is developing; this is a simplified figure created for the purpose of this publication. Created in BioRender.com.