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Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation
Published on: May 16, 2016
Renal involvement in the systemic inflammatory reaction syndrome
A M Karnik1, R Bashir, F A Khan
1Department of Medicine, Nassau County Medical Center and State University of New York at Stony Brook 11554, USA.
Renal Failure
|March 24, 1998
Summary
Systemic inflammatory reaction syndrome (SIRS) primarily affects elderly patients with low albumin levels. While premenopausal women appear protected, acute renal failure (ARF) complicates SIRS, impacting outcomes and mortality.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Nephrology
Background:
- Uncontrolled infections frequently lead to systemic inflammatory reaction syndrome (SIRS) and multiorgan dysfunction (MOD).
- SIRS is a critical condition requiring intensive monitoring and management.
Purpose of the Study:
- To investigate the demographic, clinical, and prognostic factors in patients with SIRS.
- To identify predictors of acute renal failure (ARF) and mortality in SIRS patients.
Main Methods:
- Prospective enrollment of 35 SIRS patients in two multicenter, double-blind trials.
- Detailed monitoring of patient demographics, infection sources, laboratory values (serum albumin, creatinine), and outcomes up to day 28.
- Statistical analysis of demographic differences and outcome correlations.
Main Results:
- SIRS predominantly affected elderly males; premenopausal women showed a protective effect.
- Low serum albumin levels were uniformly observed in SIRS patients.
- 63% of SIRS patients developed ARF; gram-positive organisms were common in blood cultures.
- ARF patients had slower SIRS resolution; renal function improvement predicted better prognosis.
- Overall mortality was ~32%, with no significant difference between ARF and non-ARF groups. Concurrent ARF and ARDS indicated non-survival.
Conclusions:
- SIRS is associated with elderly demographics, low albumin, and a potential protective effect in premenopausal women.
- ARF is a common complication of SIRS, influencing recovery timelines but not overall mortality.
- Gram-positive infections are prevalent; improving renal function is a positive prognostic indicator.
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