Renal impairment and mortality in cirrhotic patients with spontaneous bacterial peritonitis: role of proinflammatory cytokines and a possible role of intercellular adhesion molecule-1

ABSTRACT

This study included 32 cirrhotic patients with spontaneous bacterial peritonitis [SBP] aged 36.3 +/- 5.3 years, 15 cirrhotic patients with sterile ascitic fluid aged 37.1 +/- 4.1 years and 15 age- matched healthy control subjects. Serum bilirubin, serum albumin, serum creatinine, CBC, ascitic fluid polymorphonuclear leucocytes [PMNL], plasma and ascitic fluid levels of TNF-alpha, IL-6 and sICAM-1, abdominal X-ray and ultrasonography were assessed. It was concluded that cirrhotic patients with SBP have an abnormal inflammatory and immune responses in terms of increased ascitic fluid and plasma levels of TNF-alpha, IL-6 and sICAM-1. SICAM-1 implies a favorable condition for PMNL migration towards the peritoneum accentuating the inflammatory and immune responses which may be an important mechanism of SBP that induced renal impairment and death