Peritonitis risk factors: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
''Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites''.<ref name="pmid25644943">{{cite journal| author=Schwabl P, Bucsics T, Soucek K, Mandorfer M, Bota S, Blacky A et al.| title=Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites. | journal=Liver Int | year= 2015 | volume= 35 | issue= 9 | pages= 2121-8 | pmid=25644943 | doi=10.1111/liv.12795 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25644943 }} </ref> | === Biochemical risk factors === | ||
''Well-established risk factors for developing an initial episode of SBP are'' : | |||
* Low ascitic fluid protein level (<1 g/dL) | |||
* Elevated serum bilirubin level (>4 mg/dL) | |||
* Advanced Cirrhosis | |||
* Low levels of 25-hydroxy vitamin D | |||
* Serum albumin level <2.85 g/dL | |||
=== Clinical risk factors=== | |||
* Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites. | |||
=== Genetic risk factors=== | |||
* The Toll-like receptor 2 (TLR2) proteins<ref name="pmid21356257">{{cite journal| author=Nischalke HD, Berger C, Aldenhoff K, Thyssen L, Gentemann M, Grünhage F et al.| title=Toll-like receptor (TLR) 2 promoter and intron 2 polymorphisms are associated with increased risk for spontaneous bacterial peritonitis in liver cirrhosis. | journal=J Hepatol | year= 2011 | volume= 55 | issue= 5 | pages= 1010-6 | pmid=21356257 | doi=10.1016/j.jhep.2011.02.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21356257 }} </ref> variants of the NOD2 (nucleotide-binding oligomerisation domain containing gene and Farnesoid X were known to cause SBP. | |||
=== Pharmacological risk factors=== | |||
* Proton pump inhibitors (PPI) has been associated with a three-fold increase in the risk and identified as an independent risk factor for SBP in patients with advanced cirrhosis. | |||
* Beta-adrenergic antagonists namely nonselective beta-blocker (NSBB) therapy was found to be protective for SBP. | |||
''Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites''.<ref name="pmid25644943">{{cite journal| author=Schwabl P, Bucsics T, Soucek K, Mandorfer M, Bota S, Blacky A et al.| title=Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites. | journal=Liver Int | year= 2015 | volume= 35 | issue= 9 | pages= 2121-8 | pmid=25644943 | doi=10.1111/liv.12795 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25644943 }} </ref> | |||
* Low serum sodium levels | * Low serum sodium levels | ||
* Child-Pugh stage C | * Child-Pugh stage C | ||
Revision as of 22:05, 11 January 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
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Peritonitis Main Page |
Overview
Common risk factors for peritonitis in the development of peritonitis include liver disease, dialysis, and abdominal trauma.
Risk Factors
Biochemical risk factors
Well-established risk factors for developing an initial episode of SBP are :
- Low ascitic fluid protein level (<1 g/dL)
- Elevated serum bilirubin level (>4 mg/dL)
- Advanced Cirrhosis
- Low levels of 25-hydroxy vitamin D
- Serum albumin level <2.85 g/dL
Clinical risk factors
- Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites.
Genetic risk factors
- The Toll-like receptor 2 (TLR2) proteins[1] variants of the NOD2 (nucleotide-binding oligomerisation domain containing gene and Farnesoid X were known to cause SBP.
Pharmacological risk factors
- Proton pump inhibitors (PPI) has been associated with a three-fold increase in the risk and identified as an independent risk factor for SBP in patients with advanced cirrhosis.
- Beta-adrenergic antagonists namely nonselective beta-blocker (NSBB) therapy was found to be protective for SBP.
Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites.[2]
- Low serum sodium levels
- Child-Pugh stage C
- Elevated ascites PMN counts (≥100 cells/μl)
- MELD≥22
- Elevated CRP levels
Common risk factors for peritonitis are described as follows:[3]
| Primary Peritonitis | Secondary Peritonitis | Tertiary Peritonitis |
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References
- ↑ Nischalke HD, Berger C, Aldenhoff K, Thyssen L, Gentemann M, Grünhage F; et al. (2011). "Toll-like receptor (TLR) 2 promoter and intron 2 polymorphisms are associated with increased risk for spontaneous bacterial peritonitis in liver cirrhosis". J Hepatol. 55 (5): 1010–6. doi:10.1016/j.jhep.2011.02.022. PMID 21356257.
- ↑ Schwabl P, Bucsics T, Soucek K, Mandorfer M, Bota S, Blacky A; et al. (2015). "Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites". Liver Int. 35 (9): 2121–8. doi:10.1111/liv.12795. PMID 25644943.
- ↑ Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE et al. (2016) ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int 36 (5):481-508. DOI:10.3747/pdi.2016.00078 PMID: 27282851