{"id":89732,"date":"2001-06-04T00:00:00","date_gmt":"2001-06-04T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/sindrome-hepatorrenal-nuevos-aspectos-fisiopatologicos-y-terapeuticos\/"},"modified":"2001-06-04T00:00:00","modified_gmt":"2001-06-04T00:00:00","slug":"sindrome-hepatorrenal-nuevos-aspectos-fisiopatologicos-y-terapeuticos","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/sindrome-hepatorrenal-nuevos-aspectos-fisiopatologicos-y-terapeuticos\/","title":{"rendered":"Sindrome hepatorrenal: nuevos aspectos fisiopatologicos y terapeuticos"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Susana Rosa Guevara M\u00f3nica <\/strong><\/h2>\n<p>Actualmente, la teoria m\u00e1s aceptada para explicar la fisiopatolog\u00eda de la funci\u00f3n renal es la teor\u00eda de la vasodilataci\u00f3n. Dentro de esta teoria existen varios puntos que no han podido ser esclarecidos y que han sido motivo de estudio en la presente tesis.  1.- Seg\u00fan esta teor\u00eda la vasodilataci\u00f3n se localizar\u00eda fundamentalmente a nivel del territorio espl\u00e1cnico. Los pacientes con shr presentan una vasoconstricci\u00f3n de la circulaci\u00f3n renal, braquial y femoral. Sin embargo, no existen estudios evaluando el estado de la circulaci\u00f3n cerebral en estos pacientes. 2.- Por otro lado, teniendo en cuenta que la hipertensi\u00f3n portal seria el mecanismo inicial en el desarrollo del shr, la colocaci\u00f3n de una derivaci\u00f3n percut\u00e1nea portosist\u00e9mica intrahep\u00e1tica (dppi) deberia asociarse a una mejoria de la funcion renal. 3.- Finalmente, se ha sugerido que el shr se produciria por un aumento de actividad de los sistemas vasoconstrictores secundario a una vasodilataci\u00f3n espl\u00e1cnica. Por tanto, la administraci\u00f3n de un vasoconstrictor junto con la expansi\u00f3n del volumen plasm\u00e1tico deberia disminuir la actividad de los sistemas vasoconstrictor junto con la expansi\u00f3n del volumen plasm\u00e1tico deberia disminuir la actividad de los sistemas vasoconstrictores y permitir la mejoria de la funcion renal. Con el objetivo de aclarar estos puntos se realizaron tres protocolos de estudio diferentes en los cuales se comprob\u00f3 que:  1.- La resistencia vacular cerebral, medida por el \u00edndice de resistencia en la arteria cerebral media, esta aumentada en los pacientes cirr\u00f3ticos. adem\u00e1s, los cambios en la circulaci\u00f3n cerebral se correlacionan con los cambios en la circulaci\u00f3n renal. 2.- La dppi mejora la funci\u00f3n renal y disminuye la actividad de los sistemas vasoactivos end\u00f3genos en pacientes con shr tipo 1. Por tanto, la disminuci\u00f3n de la presi\u00f3n protal se asocia a una mejoria de la funci\u00f3n renal en estos pacientes. 3- en los pacientes con shr la<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Sindrome hepatorrenal: nuevos aspectos fisiopatologicos y terapeuticos<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Sindrome hepatorrenal: nuevos aspectos fisiopatologicos y terapeuticos <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Susana Rosa Guevara M\u00f3nica <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Barcelona<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 06\/04\/2001<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Pere Gines Gibert<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: cortina Joan balalsch <\/li>\n<li> Ramon planas wladimiro jimenez (vocal)<\/li>\n<li>soriano German (vocal)<\/li>\n<li>campistoll Josep Mar\u00eda (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Susana Rosa Guevara M\u00f3nica Actualmente, la teoria m\u00e1s aceptada para explicar la fisiopatolog\u00eda de la funci\u00f3n renal [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[9481,44,951,9,189,491,139,179],"tags":[186562,186559,118653,186560,186561,186558],"class_list":["post-89732","post","type-post","status-publish","format-standard","hentry","category-absorcion-de-los-farmacos","category-accion-de-los-farmacos","category-barcelona","category-ciencias-medicas","category-farmacodinamia","category-gastroenterologia","category-medicina-interna","category-nefrologia","tag-campistoll-josep-maria","tag-cortina-joan-balalsch","tag-pere-gines-gibert","tag-ramon-planas-wladimiro-jimenez","tag-soriano-german","tag-susana-rosa-guevara-monica"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/89732","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=89732"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/89732\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=89732"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=89732"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=89732"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}