Functional renal failure and haemorrhagic gastritis associated with endotoxaemia in cirrhosis

Forty-three patients with cirrhosis and ascites, 21 with normal renal function, 10 with a progressive functional renal failure (FRF), and 12 with a steady FRF, were investigated for the presence of endotoxaemia by the Limulus lysate test. Endotoxaemia was found in nine patients with FRF and in none...

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Detalles Bibliográficos
Autores: Clemente, C., Bosch i Genover, Jaume, Rodés, J., Arroyo, Vicente, Mas Comas, Ana M., Maragall, S.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:1977
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/18642
Acceso en línea:https://hdl.handle.net/2445/18642
Access Level:acceso abierto
Palabra clave:Insuficiència renal aguda
Cirrosi hepàtica
Hemorràgia gastrointestinal
Endotoxines
Gastritis
Hepatic cirrhosis
Acute renal failure
Gastrointestinal hemorrhage
Endotoxins
Descripción
Sumario:Forty-three patients with cirrhosis and ascites, 21 with normal renal function, 10 with a progressive functional renal failure (FRF), and 12 with a steady FRF, were investigated for the presence of endotoxaemia by the Limulus lysate test. Endotoxaemia was found in nine patients with FRF and in none of the 21 with normal renal function (P less than 0-01). A positive Limulus test was almost exclusively associated with a progressive FRF (eight of 10 patients) and all but one of them died. Renal function improved as endotoxaemia disappeared in the survivor. Endotoxaemia was also associated with haemorrhage due to acute erosions of the gastric mucosa, being present in six of the seven patients who had this complication. Intravascular coagulation was not found in any patient. The Limulus test was positive in the ascitic fluid in 18 of 21 patients tested, although only two of them had peritonitis. These results suggest that endotoxaemia may play a critical role in the development of progressive renal failure and haemorrhagic gastritis in cirrhosis, and emphasise the potential risk of procedures involving reinfusion of ascitic fluid.