{"id":88917,"date":"2018-03-10T00:13:59","date_gmt":"2018-03-10T00:13:59","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/insuficiencia-renal-asociada-a-peritonitis-bacteriana-espontanea-mecanismos-de-aparicion-y-efecto-del-tratamiento-con-expansion-de-volumen\/"},"modified":"2018-03-10T00:13:59","modified_gmt":"2018-03-10T00:13:59","slug":"insuficiencia-renal-asociada-a-peritonitis-bacteriana-espontanea-mecanismos-de-aparicion-y-efecto-del-tratamiento-con-expansion-de-volumen","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/insuficiencia-renal-asociada-a-peritonitis-bacteriana-espontanea-mecanismos-de-aparicion-y-efecto-del-tratamiento-con-expansion-de-volumen\/","title":{"rendered":"Insuficiencia renal asociada a peritonitis bacteriana espont\u00e1nea: mecanismos de aparici\u00f3n y efecto del tratamiento con expansi\u00f3n de volumen"},"content":{"rendered":"<h2>Tesis doctoral de <strong>  Urm\u00e1n Fern\u00e1ndez Jes\u00fas M. <\/strong><\/h2>\n<p>1,- los pacientes con disfunci\u00f3n circulatoria asociada a la pbe presentan en el momento del diagn\u00f3stico una reducci\u00f3n significativa de la volemia efectiva, estimada a trav\u00e9s de la cifra de arp, respecto a los pacientes sin disfunci\u00f3n circulatoria y a los pacientes cirr\u00f3ticos con ascitis no infectada. Este importante deterioro de la volemia empeora durante el tratamiento de la infecci\u00f3n con antibi\u00f3ticos y se asocia con el desarrollo de un deterioro hemodin\u00e1mico y renal progresivos. As\u00ed a pesar de la curaci\u00f3n de la infecci\u00f3n, estos pacientes presentan un deterioro hemodin\u00e1mico significativo consistente en una disminuci\u00f3n del gasto card\u00edaco y un aumento de las resistencias vasculares sist\u00e9micas respecto a los pacientes sin disfunci\u00f3n circulatoria y respecto a los pacientes sin pbe. Este deterioro hemodin\u00e1mico se acompa\u00f1\u00f3 al final del ingreso de un deterioro significativo de la funci\u00f3n renal y hep\u00e1tica.  2,- los pacientes sin disfunci\u00f3n circulatoria asociada a la pbe presentan inicialmente una acentuaci\u00f3n de su estado hiperdin\u00e1mico basal, caracterizado por un aumento significativo del gasto card\u00edaco junto con un significativo descenso de las resistencias vasculares sist\u00e9micas respecto a los pacientes con ascitis no infectada. Tras la curaci\u00f3n de la infecci\u00f3n, estos pacientes revierten el estado hiperdin\u00e1mico regresando a valores de gasto card\u00edaco y de resistencias vasculares sist\u00e9micas similares a los de los pacientes cirr\u00f3ticos sin pbe. Este patr\u00f3n hemodin\u00e1mico no se acompa\u00f1a de una significativa activaci\u00f3n de los sistemas vasoactivos end\u00f3genos (arp, sistema nervioso simp\u00e1tico, etc.) Ni de un deterioro de la funci\u00f3n renal ni hep\u00e1tica.  3,- la respuesta inflamatoria desencadenada por la pbe y estimada a trav\u00e9s de los niveles de tnfalfa en l\u00edquido asc\u00edtico en el momento de la inclusi\u00f3n, guarda una relaci\u00f3n directa con el deterioro de la funci\u00f3n circulatoria estimado a trav\u00e9s de los niveles de arp<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Insuficiencia renal asociada a peritonitis bacteriana espont\u00e1nea: mecanismos de aparici\u00f3n y efecto del tratamiento con expansi\u00f3n de volumen<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Insuficiencia renal asociada a peritonitis bacteriana espont\u00e1nea: mecanismos de aparici\u00f3n y efecto del tratamiento con expansi\u00f3n de volumen <\/li>\n<li><strong>Autor:<\/strong>\u00a0  Urm\u00e1n Fern\u00e1ndez Jes\u00fas M. <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Alcal\u00e1<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 16\/02\/2001<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>del Ruiz<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: melchor Alvarez de mon soto <\/li>\n<li>wladimiro Jim\u00e9nez povedano (vocal)<\/li>\n<li>agustin Caro paton gomez (vocal)<\/li>\n<li>Emilio Vicente l\u00f3pez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Urm\u00e1n Fern\u00e1ndez Jes\u00fas M. 1,- los pacientes con disfunci\u00f3n circulatoria asociada a la pbe presentan en el [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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