Spontaneous bacterial peritonitis is frequently associated with renal failure.
|8 patients developed renal failure during treatment.|
In this study, researchers from Spain assessed whether systemic and hepatic hemodynamics were also altered by this condition.
The team evaluated 23 patients with spontaneous bacterial peritonitis, both at diagnosis and after infection resolution. They assessed tumor necrosis factor alpha (TNF-alpha) in plasma and ascitic fluid, plasma renin activity (PRA) and norepinephrine (NE), as well as systemic and hepatic hemodynamics.
The team found that 8 of the patients developed renal failure during treatment. At diagnosis, these patients had higher levels of TNF-alpha, blood urea nitrogen (BUN), PRA and NE, peripheral vascular resistance, and hepatic venous pressure gradient (HVPG) and lower cardiac output.
The team determined that changes in PRA and NE correlated inversely with changes in arterial pressure and directly with changes in BUN, Child-Pugh score, and HVPG.
There were 5 patients in the renal failure group who developed encephalopathy. Overall, 6 patients in this group died.
Dr Luis Ruiz-del-Arbol's team concluded, "Patients with spontaneous bacterial peritonitis frequently develop a rapidly progressive impairment in systemic hemodynamics".
This leads to, "Severe renal and hepatic failure, aggravation of portal hypertension, encephalopathy, and death".
"This occurs despite rapid resolution of infection and is associated with an extremely poor prognosis".