RENAL IMPAIREMENT FOLLOWING SPONTANEOUS BACTERIAL PERITONITIS AMONG PATIENTS SUFFERING FROM CIRRHOSIS: ASESSMENT OF INCIDENCE AND MORTALITY RATE

Background: Spontaneous bacterial peritonitis (SBP) is an important complication in cirrhotic patients. Despite it being recognized as a precipitating factor of renal impairment in cirrhosis, no study specifically addressing this problem has been reported.Objective: The aim of the present study is to assess the incidence and mortality rate of renal impairment (RI) after SBP among cirrhotic patients. Methods: This cross-sectional, observational analysis was carried out at the Dept. of Medicine at Indus Medical College and Liaquat University Hospital, Hyderabad from January 2017 to July 2018 on a sample of 582 cirrhotic patients (chosen via non-probability, consecutive sampling) admitted to the study settings. SBP diagnosis was established when the ascitic fluid polymorphonuclear cell count was equal to or greater than 250 cells/mm(3). After taking written informed consent from the study subjects, data was collected using a pre-structured, interview based questionnaire containing inquiries about basic sociodemographic details, clinical examinations details and particulars of laboratory investigation. The data obtained was analyzed using MS. Excel 360 and SPSS v. 21.0.Result: The mean age of sample stood at 51 years (SD +/- 7.5) and most of the subjects (70.96%) were males. The incidence of SBP was 23.02%. Among the 134 total cases of SBP, in 61 (45.52%) episodes, SBP was associated with RI (transient in 50.82%; steady in 21.31%; and progressive in 27.87%). The mortality rate associated with progressive RI was 100%; 53.85% with steady RI; and 9.68% with transient RI. The mortality rate in patients with or without RI was 44.26% and 8.06%, respectively (P<0.01). Conclusion: After carefully considering the results, it can be concluded that RI after SBP is a common complication, and indicates a poor prognosis for this infection.