Diuretic-induced azotemia: unmasking the role of increased peripheral catabolism through evisceration-hepatectomy.

By abolishing the large splanchnic uptake of amino acids, evisceration-hepatectomy unmasks the tendency for peripheral tissues to release increased amounts of amino acids into the extracellular fluid during sodium depletion. The increase in amino acid delivery to the liver may stimulate hepatic urea synthesis both by providing more substrates for conversion to urea and perhaps also by stimulation of the activity of urea cycle enzymes.