Abstract

Background: We studied TNF alpha and IL 6 level in cirrhotic patient with SABP and their correlation to hepatic and renal impairment and mortality.
Methods: This was a prospective correlational study and 100 consecutive patients with cirrhosis and ascites were studied. Serum and Ascitic Fluid were collected at Study entry and 48 hours later. Fluid was sent for cell count, biochemical assay, culture and sensitivity. Assays for TNF alpha and IL 6 in the serum and ascitic fluid were performed with ELISA using manufacturer’s instructions.
Results: Out of 100 patients –57 were in group I (Group with SABP) and 43 were in group II (Group without SABP). Out of 57 patients of group I, 25 were in Group Ia (with Renal Impairment) and 32 were in Group Ib (without Renal Impairment). Group Ia, all patients belonged to Child Score C. The level of cytokines in serum and ascitic fluid correlated significantly in this group and also significantly correlated with mortality.
Conclusion: In group Ia level of TNF alpha and IL 6 rise was statistically significant and significantly correlated with mortality as all of the patients of this group had CTP scoring of Child C. The cytokines production enhances liver cell injury leading to renal impairment and levels correlated well with poor prognosis and mortality seen in SABP in cirrhotic patients with renal impairment. We conclude, that measurement of the cytokines levels is a non-invasive simple method for diagnosis and prognostication in cirrhosis patients.
Keywords: Cytokines, cirrhosis and subacute bacterial peritonitis, TNF alpha and IL6 in cirrhosis with renal failure, subacute bacterial peritonitis with renal failure.