REN and Cirrhosis: Furthermore, the persistent overflow of PAMPs and their translocation in the systemic circulation contributes to worsening the pre-existing hyperdynamic circulation associated with cirrhosis, leading to uncontrolled systemic vasodilation, impaired cardiac output, and hypotension, with a compensatory hyperactivation of the renin–angiotensin–aldosterone system that also precipitates cirrhosis decompensation [31].