Rifaximin Improves Systemic Hemodynamics and Renal Function in Patients with Alcohol-Related Cirrhosis and Ascites.
Clin Gastroenterol Hepatol. 2012 Mar 2;
Authors: Kalambokis GN, Mouzaki A, Rodi M, Pappas K, Fotopoulos A, Xourgia X, Tsianos EV
Abstract
Circulating levels of endotoxin, interleukin (IL)-6, and tumor necrosis factor (TNF)-? increase with intestinal bacterial overgrowth and translocation, and are believed to be involved in the pathogenesis of hyperdynamic circulatory syndrome and functional renal failure in patients with advanced cirrhosis. We investigated the effects of the antibiotic rifaximin on systemic hemodynamics and renal function in patients with alcohol-related cirrhosis and ascites. We measured mean arterial pressure, cardiac output (CO, by Doppler ultrasound), systemic vascular resistance (as the ratio mean arterial pressure:CO), plasma rennin activity (PRA), levels of plasma aldosterone, the glomerular filtration rate (GFR, by plasma clearance of Tc(99m) -DTPA), natriuresis, levels of plasma endotoxin, and serum levels of IL-6 and TNF-? in 13 patients at baseline and after 4 weeks of treatment with rifaximin. Rifaximin treatment significantly reduced CO and significantly increased systemic vascular resistance, in association with a significant decrease in PRA. The therapy also significantly increased the GFR and natriuresis while reducing levels of endotoxin, IL-6, and TNF-?. Intestinal decontamination with rifaximin improved systemic hemodynamics and renal function in patients with advanced cirrhosis.
PMID: 22391344 [PubMed - as supplied by publisher]