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[Renal dysfunction after spontaneous bacterial peritonitis in cirrhosis: incidence and risk factors. |
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[Renal dysfunction after spontaneous bacterial peritonitis in cirrhosis: incidence and risk factors.]
[Article in Korean]
Korean J Gastroenterol. 2006 Dec;48(6):401-7.
Jung ES, Lee JS, Kim MH, Kim NH, Kim KA, Moon YS.
Department of Internal Medicine, College of Medicine, Inje University, Ilsanpaik Hospital, Goyang, Korea.
Background/Aims:
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.
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