Rifaximin Improves Systemic Hemodynamics and Renal Function in Patients With Alcohol-Related Cirrhosis and Ascites
Abstract
Circulating levels of endotoxin, interleukin (IL)-6, and tumor necrosis factor (TNF)-α 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 of mean arterial pressure:CO), plasma renin activity, levels of plasma aldosterone, the glomerular filtration rate by plasma clearance of technetium-99m-DTPA, natriuresis, levels of plasma endotoxin, and serum levels of IL-6 and TNF-α 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 plasma rennin activity. The therapy also significantly increased the glomerular filtration rate and natriuresis while reducing levels of endotoxin, IL-6, and TNF-α. Intestinal decontamination with rifaximin improved systemic hemodynamics and renal function in patients with advanced cirrhosis.
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Rifaximin appears to reduce spontaneous bacterial peritonitis and may improve portal hypertension, suggesting it effectively targets the gut-liver axis in advanced liver disease.
“Moreover, rifaximin appears to reduce the development of spontaneous bacterial peritonitis and may improve portal hypertension, suggesting that it effectively targets the gut–liver axis in advanced liver disease93,114,115.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [115]
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- Authors
- Kalambokis, G. N., Mouzaki, A., Rodi, M., Pappas, K., Fotopoulos, A., Xourgia, X., & Tsianos, E. V.
- Affiliations
- University of Ioannina (GR)
- University of Patras (GR)
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 10
- Issue
- 7
- Pages
- 815-818
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W1999133483
- Cited by
- 130
- References
- 21
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 13 · 2022: 9 · 2021: 14 · 2020: 6 · 2019: 16 · 2018: 11 · 2017: 8 · 2016: 8 · 2015: 15 · 2014: 9 · 2013: 6 · 2012: 2
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Keywords
- rifaximin, alcoholic cirrhosis, ascites, systemic hemodynamics, renal function, glomerular filtration rate, sodium excretion, plasma renin activity, plasma aldosterone, endotoxin, interleukin-6, TNF-α, intestinal bacterial overgrowth, intestinal decontamination, systemic vascular resistance, cardiac output
- MeSH terms
- Rifaximin, Anti-Bacterial Agents, Ascites, Blood Pressure, Cardiac Output, Endotoxins, Hemodynamics, Humans, Kidney, Kidney Function Tests, Liver Cirrhosis, Alcoholic, Male, Middle Aged, Pilot Projects, Prospective Studies, Renin, Rifamycins, Tumor Necrosis Factor-alpha, Interleukin-6, Treatment Outcome
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