Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1976 Dec 11;2(6049):1415–1418. doi: 10.1136/bmj.2.6049.1415

Endotoxaemia and renal failure in cirrhosis and obstructive jaundice.

S P Wilkinson, H Moodie, J D Stamatakis, V V Kakkar, R Williams
PMCID: PMC1690371  PMID: 795499

Abstract

An investigation into the possible role of endotoxins in the pathogenesis of renal failure in cirrhosis and obstructive jaundice showed the two to be closely related. None of the patients with cirrhosis who had endotoxaemia had other evidence of Gram-negative infection at the time of the study, and the endotoxaemia was therefore probably due to impaired hepatic clearance of toxins normally absorbed from the gastrointestinal tract. In contrast, bacteriological evidence of Gram-negative infection was found in most of the patients with obstructive jaundice and endotoxaemia.

Full text

PDF
1417

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bjorneboe M., Prytz H., Orskov F. Antibodies to intestinal microbes in serum of patients with cirrhosis of the liver. Lancet. 1972 Jan 8;1(7741):58–60. doi: 10.1016/s0140-6736(72)90060-8. [DOI] [PubMed] [Google Scholar]
  2. Braude A. I., Douglas H., Davis C. E. Treatment and prevention of intravascular coagulation with antiserum to endotoxin. J Infect Dis. 1973 Jul;128(Suppl):157–164. doi: 10.1093/infdis/128.supplement_1.s157. [DOI] [PubMed] [Google Scholar]
  3. Drivas G., James O., Wardle N. Study of reticuloendothelial phagocytic capacity in patients with cholestasis. Br Med J. 1976 Jun 26;1(6025):1568–1569. doi: 10.1136/bmj.1.6025.1568. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dévényi I., Szücs L., Tessmann D., Schill H. Renale mastocytose und sekundärer Aldosteronismus. Virchows Arch A Pathol Pathol Anat. 1968;345(3):238–244. [PubMed] [Google Scholar]
  5. Elin R. J., Wolff S. M. Nonspecificity of the limulus amebocyte lysate test: positive reactions with polynucleotides and proteins. J Infect Dis. 1973 Sep;128(3):349–352. doi: 10.1093/infdis/128.3.349. [DOI] [PubMed] [Google Scholar]
  6. Epstein M., Berk D. P., Hollenberg N. K., Adams D. F., Chalmers T. C., Abrams H. L., Merrill J. P. Renal failure in the patient with cirrhosis. The role of active vasoconstriction. Am J Med. 1970 Aug;49(2):175–185. doi: 10.1016/s0002-9343(70)80073-0. [DOI] [PubMed] [Google Scholar]
  7. GARCEAU A. J., CHALMERS T. C. The natural history of cirrhosis. I. Survival with esophageal varices. N Engl J Med. 1963 Feb 28;268:469–473. doi: 10.1056/NEJM196302282680905. [DOI] [PubMed] [Google Scholar]
  8. GILLENWATER J. Y., DOOLEY E. S., FROHLICH E. D. EFFECTS OF ENDOTOXIN ON RENAL FUNCTION AND HEMODYNAMICS. Am J Physiol. 1963 Aug;205:293–297. doi: 10.1152/ajplegacy.1963.205.2.293. [DOI] [PubMed] [Google Scholar]
  9. Jedrychowski A., Hillenbrand P., Ajdukiewicz A. B., Parbhoo S. P., Sherlock S. Fibrinolysis in cholestatic jaundice. Br Med J. 1973 Mar 17;1(5854):640–642. doi: 10.1136/bmj.1.5854.640. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. KWAAN H. C., MCFADZEAN A. J., COOK J. Plasma fibrinolytic activity in cirrhosis of the liver. Lancet. 1956 Jan 21;270(6908):132–136. doi: 10.1016/s0140-6736(56)91093-5. [DOI] [PubMed] [Google Scholar]
  11. Kocsár L. T., Bertók L., Várterész V. Effect of bile acids on the intestinal absorption of endotoxin in rats. J Bacteriol. 1969 Oct;100(1):220–223. doi: 10.1128/jb.100.1.220-223.1969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Liehr H., Grün M., Brunswig D., Sautter T. Letter: Endotoxaemia in liver cirrhosis: treatment with polymyxin B. Lancet. 1975 Apr 5;1(7910):810–811. doi: 10.1016/s0140-6736(75)92482-4. [DOI] [PubMed] [Google Scholar]
  13. Nolan J. P., Ali M. V. Effect of cholestyramine on endotoxin toxicity and absorption. Am J Dig Dis. 1972 Feb;17(2):161–166. doi: 10.1007/BF02232738. [DOI] [PubMed] [Google Scholar]
  14. Reinhold R. B., Fine J. A technique for quantitative measurement of endotoxin in human plasma. Proc Soc Exp Biol Med. 1971 May;137(1):334–340. doi: 10.3181/00379727-137-35572. [DOI] [PubMed] [Google Scholar]
  15. Ring-Larsen H., Hesse B., Stigsby B. Effect of portacaval anastomosis on renal blood flow in cirrhosis--preliminary results. Postgrad Med J. 1975 Aug;51(598):499–502. doi: 10.1136/pgmj.51.598.499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. SHEAR L., KLEINERMAN J., GABUZDA G. J. RENAL FAILURE IN PATIENTS WITH CIRRHOSIS OF THE LIVER. I. CLINICAL AND PATHOLOGIC CHARACTERISTICS. Am J Med. 1965 Aug;39:184–198. doi: 10.1016/0002-9343(65)90041-0. [DOI] [PubMed] [Google Scholar]
  17. Stewart D., Blendis L. M., Williams R. Studies on the prekallikrein-bradykininogen system in liver disease. J Clin Pathol. 1972 May;25(5):410–414. doi: 10.1136/jcp.25.5.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Stumacher R. J., Kovnat M. J., McCabe W. R. Limitations of the usefulness of the Limulus assay for endotoxin. N Engl J Med. 1973 Jun 14;288(24):1261–1264. doi: 10.1056/NEJM197306142882402. [DOI] [PubMed] [Google Scholar]
  19. Triger D. R., Alp M. H., Wright R. Bacterial and dietary antibodies in liver disease. Lancet. 1972 Jan 8;1(7741):60–63. doi: 10.1016/s0140-6736(72)90061-x. [DOI] [PubMed] [Google Scholar]
  20. Wardle E. N. Endotoxin and acute renal failure. Nephron. 1975;14(5):321–332. doi: 10.1159/000180463. [DOI] [PubMed] [Google Scholar]
  21. Wardle E. N., Wright N. A. Endotoxin and acute renal failure associated with obstructive jaundice. Br Med J. 1970 Nov 21;4(5733):472–474. doi: 10.1136/bmj.4.5733.472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wilkinson S. P., Arroyo V., Gazzard B. G., Moodie H., Williams R. Relation of renal impairment and haemorrhagic diathesis to endotoxaemia in fulminant hepatic failure. Lancet. 1974 Mar 30;1(7857):521–524. doi: 10.1016/s0140-6736(74)92711-1. [DOI] [PubMed] [Google Scholar]
  23. Wong P., Colman R. W., Talamo R. C., Babior B. M. Kallikrein-bradykinin system in chronic alcoholic liver disease. Ann Intern Med. 1972 Aug;77(2):205–209. doi: 10.7326/0003-4819-77-2-205. [DOI] [PubMed] [Google Scholar]
  24. Yin E. T. Endotoxin, thrombin, and the Limulus amebocyte lysate test. J Lab Clin Med. 1975 Sep;86(3):430–434. [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES