Abstract
Comparison of Outcomes between Spontaneous Bacterial Peritonitis and Culture Negative Neutrocytic Ascites among Liver Cirrhosis Patients with End-Stage Renal Disease on Hemodialysis
Jose Orlando M. Nicolas, MD; Jade D. Jamias, MD
National Kidney and Transplant Institute
Significance: Chronic kidney disease (CKD) is an independent risk factor that affects mortality among cirrhotic patients with ascitic fluid infections. The aim of this study is to determine the outcomes between spontaneous bacterial peritonitis (SBP) and culture-negative neutrocytic ascites (CNNA) among patients with CKD on hemodialysis.
Methodology: Between January 2011 to January 2024, 308 patients with liver cirrhosis and CKD who had SBP and CNNA were evaluated. All patients underwent abdominal paracentesis and the ascitic fluid was processed for cell count and culture. Clinical and laboratory parameters of these patients were recorded at index admission to determine if there is difference on the 7-day, 14-day, and 30-day outcomes (discharged, prolonged admission, and mortality).
Results: Out of 308 patients included in the study, 201 patients (65.3%) were SBP and 107 patients (34.7%) were CNNA. Baseline characteristics, incidence of hepatic encephalopathy, and variceal bleeding did not differ between the two groups. Gram-negative bacteria accounted for 97.02% of the identified pathogens. Using logistic regression analysis, decreased platelet count, increased blood polymorphonuclear, and increased ascitic polymorphonuclear cells are independent predictor factors for culture positive SBP. In this study, patients with CKD on hemodialysis and liver cirrhosis who had SBP and CNNA had 62.69% and 88.78%, overall mortality respectively.
Conclusion: Patients with liver cirrhosis and chronic kidney disease on hemodialysis who had SBP and CNNA have similar seven-day, 14-day, and 30-day mortality rates. The dual burden of kidney and liver impairment leads to overall worsened outcomes.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |