[Renal dysfunction after spontaneous bacterial peritonitis in cirrhosis: incidence and risk factors].
OBJECTIVE
Deterioration of renal function in patients with cirrhosis and spontaneous bacterial peritonitis (SBP) is the most sensitive predictor of in-hospital mortality. It has been shown that high dose intravenous albumin in addition to antibiotics reduces the incidence of renal impairment and improve hospital survival in these patients. Besides, it is important to know which patients would benefit from albumin infusion. Therefore, we conducted a retrospective study to elucidate the incidence and risk factors of renal dysfunction in cirrhotic patients with SBP.


METHODS
All medical records of 76 consecutive episodes of SBP in 60 patients were analyzed. Renal dysfunction after SBP was defined as elevation of BUN >30 mg/dL or serum creatinine >1.5 mg/dL in patients without preexisting renal insufficiency, or elevation of more than 50% of the baseline level in patients with renal dysfunction at the diagnosis of infection.


RESULTS
Of the 76 episodes, renal dysfunction was present in 31 (40.8%). Age, concurrent use of diuretics, large volume paracentesis (LVP) with volume expander, initial BUN and creatinine level were significant risk factors on univariate analysis. Of these, age and LVP were independent risk factors on logistic regression model.


CONCLUSIONS
Renal dysfunction occurs in 40.8% of hospitalized patients after SBP. Considering poor prognosis of patients with renal dysfunction in SBP, close monitoring of renal function is needed and high dose intravenous albumin with antibiotics should be used especially in the elderly and those with LVP.
Jung
Eun Sook
ES
Department of Internal Medicine, College of Medicine, Inje University, Ilsanpaik Hospital, Ilsan-Gu, Goyang, Korea.
Lee
June Sung
JS
Kim
Min Hwan
MH
Kim
Nam Hoon
NH
Kim
Kyung A
KA
Moon
Young Soo
YS
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D012307:Risk Factors