Volume 134, Issue 1, Pages 111-119.e2 (January 2008) Relationship Between Activation of the Sympathetic Nervous System and Renal Blood Flow Autoregulation in Cirrhosis  Vanessa P. Stadlbauer, Gavin A.K. Wright, Murad Banaji, Ashis Mukhopadhya, Rajeshwar Mookerjee, Kevin Moore, Rajiv Jalan  Gastroenterology  Volume 134, Issue 1, Pages 111-119.e2 (January 2008) DOI: 10.1053/j.gastro.2007.10.055 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 (A) Relation of renal blood flow to renal perfusion pressure, using the data from Figure 2A from Persson et al17 for normal dogs, along with our model curve. Original data use renal arterial pressure rather than renal perfusion pressure, so a venous pressure of 8 mm Hg was subtracted to get the approximate perfusion pressure values. (B) Hypothesis on the influence of vasoconstrictory stimuli on the renal blood flow autoregulation curve using our model curve derived from the data in the report by Persson et al.17 Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 (A) Correlation of renal blood flow with cardiac output (r2 = .37; P < .0001). (B) Correlation of renal blood flow with norepinephrine levels (r2 = .78; P < .0001). Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions

Figure 3 Renal blood flow versus renal perfusion pressure for each of the 4 patient groups, along with the model “best-fit” curves. As described, for the first group 1, α was set at 0. Values of α = 3.3, α = 8.7, and α = 18.3 were obtained by the fitting process for groups 2, 3, and 4, respectively. +, preascitic; open squares, diuretic-responsive ascites; ×, diuretic-resistant ascites; *, HRS. Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions

Figure 4 Three-dimensional blot showing the influence of renal blood flow and norepinephrine on renal perfusion pressure in patients without ascites, diuretic-responsive ascites, diuretic-resistant ascites, and HRS. Open squares, preascitic; open diamonds, diuretic-responsive ascites; closed circles, diuretic-resistant ascites; open triangles, HRS. Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions

Figure 5 Renal blood flow versus renal perfusion pressure for the patient group that underwent insertion of a TIPS, before and after the insertion, along with the model “best-fit” curves. Values of α = 6.7 and α = 4.5 were obtained for the patient group before and after insertion of a TIPS, respectively. Open squares, before insertion of a TIPS; +, after insertion of a TIPS. Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions

Figure 6 Three-dimensional plot showing the relationship among renal blood flow, norepinephrine levels, and renal perfusion pressure in patients before and after insertion of a TIPS. Closed triangles, before insertion of a TIPS; open squares, after insertion of a TIPS. Gastroenterology 2008 134, 111-119.e2DOI: (10.1053/j.gastro.2007.10.055) Copyright © 2008 AGA Institute Terms and Conditions