REN and fibrosis: Anothercontributing factor is the degree of structural changes within the hepatocytes dueto fibrosis, nodule formation, and vascular occlusion (depending on the degree ofcirrhosis).5 In turn, the body undergoes changes in hemodynamics to maintainblood flow by the renin-angiotensin-aldosterone system (RAAS) activation,anti-diuretic hormone (ADH) secretion, sympathetic nervous system regulation, andincreased production of endogenous vasoconstrictors.