Asunto(s)
Insuficiencia Cardíaca/diagnóstico , Alveolos Pulmonares/patología , Edema Pulmonar/diagnóstico , Síndrome de Dificultad Respiratoria/diagnóstico , Anciano , Neoplasias Colorrectales/patología , Diagnóstico Diferencial , Diagnóstico por Imagen/métodos , Progresión de la Enfermedad , Disnea/diagnóstico , Resultado Fatal , Humanos , Neoplasias Hepáticas/secundario , MasculinoAsunto(s)
Encefalopatía Hepática , Cirrosis Hepática , Trasplante de Hígado , Enfermedades de la Médula Espinal , Encefalopatía Hepática/etiología , Encefalopatía Hepática/cirugía , Hepatitis C/complicaciones , Humanos , Cirrosis Hepática/etiología , Cirrosis Hepática/cirugía , Masculino , Persona de Mediana Edad , Paraparesia/fisiopatología , Paraparesia/cirugía , Recuperación de la Función , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/fisiopatología , Enfermedades de la Médula Espinal/cirugía , Resultado del TratamientoRESUMEN
UNLABELLED: The aim of the study was to investigate the prevalence and clinical course of renal failure that was induced by the various types of bacterial infections in patients with cirrhosis and ascites. Three hundred and nine patients, who were consecutively admitted to the 3 major hospitals of Padova, Italy, during the first 6 months of 2005, were studied prospectively. Of these, 233 patients (75.4%) had evidence of ascites. In 104 patients with cirrhosis and ascites (44.6%) a bacterial infection was diagnosed. A bacterial infection-induced renal failure was observed in 35 of 104 patients (33.6%). The prevalence of renal failure was higher in biliary or gastrointestinal tract infections and in spontaneous bacterial peritonitis (SBP) and in than in other types of infections. In addition, the progressive form of renal failure was only precipitated by biliary or gastrointestinal tract infections, SBP, and urinary tract infections (UTI). In a multivariate analysis only MELD score (P = 0.001), the peak count of neutrophil leukocyte in blood (P = 0.04), and the lack of resolution of infection (P = 0.03) had an independent predictive value on the occurrence of renal failure. CONCLUSION: The results of the study show that the development of bacterial-induced renal failure in patients with cirrhosis and ascites is related to the MELD score, and to both the severity and the lack of resolution of the infection. A progressive form of renal failure occurs only as a consequence of biliary or gastrointestinal tract infections, SBP, and UTI.