Cirrhosis: decrease in plasma protein synthesis in the liver and renal sodium retention

A similar sequence of events occurs in cirrhosis as in nephrotic syndrome, except in cirrhosis, a decrease in plasma protein levels results from the destruction of hepatocytes, thereby reducing the overall likelihood of adequate plasma proteins of the liver.

Cirrhosis is also involved in a large amount of fibrous tissue in the liver structure, which greatly interferes with the flow of blood through the liver. This impedance in turn increases the capillary pressure throughout the portal bed, which also contributes to the leakage of fluid and protein into the peritoneal cavity, a condition known as ascites.

When fluid and protein are lost from the circulation, the kidney reactions are similar to those observed in other conditions involving a decrease in plasma volume.

That is, the kidneys continue to hold salt and water until the plasma volume and arterial pressure are restored to normal. In some cases, the actual plasma volume may increase above normal due to increased vascular capacity in cirrhosis; The high pressure in the portal circulation can dilate the veins and thus increase the vein capacity.