الفهرس | Only 14 pages are availabe for public view |
Abstract Background: SBP is the commonest infection in cirrhosis leading to serious outcomes including renal impairment (RI) or death. Several mechanisms by which renal dysfunction occurs in patients with SBP. One of them is systemic inflammatory response syndrome (SIRS) induced (RI) through release of proinflammatory cytokines e.g; IL-6, TNF-α and VCAM-1 which stimulate release of nitric oxide (NO) that decreases effective plasma volume with its consequences including renal perfusion. Aim: To evaluate the role of IL-6, TNF-α and VCAM-1 as predictors of renal impairment & outcomes in cirrhotic patients with SBP. Subjects and methods: This Cross-sectional study was conducted on 90 cirrhotic patients with SBP in Kasr Al-Ainy hospital & NHTMRI. RI is considered when creatinine >1.3, Accordingly, the studied patients were divided into group A (n=45) 50% of the patients (no RI) & group B with (RI). According to the outcome, The patients were divided into group 1(discharge) & group 2 (death) (n=20) 22.2% of patients. TNF-α, IL-6 & Vcam1 were measured in the serum by ELISA by (NOVA, Bioneovan Co., China). Results: RI occurred in 50% of patients. The cytokine levels were high in 11.1%, 8.9% and 6.7% for IL-6, TNF-α and VCAM-1 respectively. We found no statistically significant difference in cytokines levels between group A & B or between group 1 & 2. The AUC was 0.5 for the three cytokines with equal sensitivity and specificity 93% and 97% respectively as predictors of RI. While the AUC for IL-6, TNF-α & VCAM-1 didn’t exceed 0.6 with specificity 88%, 98% & 93% respectively & with sensitivity 95% for the three cytokines as predictors for outcomes. Conclusion: The use of IL-6, TNF-α & VCAM-1 as predictors for renal impairment & outcomes isn’t recommended as they have poor diagnostic values. |