الفهرس 
Renal involvement in infective endocarditis :Causes and its impact on in-hospital outcome
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Abstract
Background: Infective endocarditis (IE) is considered to be a global burden both socially and economically particularly in developing countries as Egypt. Renal involvement related to this disease is common and adds significantly to its rising morbidity and mortality.Purpose: In this prospective longitudinal observational study, 58 patients, diagnosed as definite or possible IE, were evaluated for the incidence and predictors of renal involvement and its impact on in-hospital outcome.Methods: Fifty eight patients were admitted to the cardiology department.They were evaluated clinically, laboratory and with various imaging modalities. Assessing renal involvement has included serum urea, creatinine level, estimated glomerular filtration rate by Cockcroft-Gault equation, urine analysis for gross or microscopic hematuria and proteinuria. Development of significant renal impairment was defined as rise of serum creatinine to 2 mg/dl or more on admission or at any point during hospital stay after exclusion chronic kidney disease patients.Results: The prevalence of renal involvement in patients with IE was 65.5%.The incidence of significant renal impairment (defined previously) was found to be 41.4%. Heart failure and shock requiring vasopressor support were highly significant predictor for significant renal impairment. Inaddition markers of sepsis, either clinical as tachycardia and hyperthermia or laboratory as high C-reactive protein level, leukocytosis, thrombocytopenia and hypoalbuminemia, have been proven to be predictors of significant renal impairment.The most common complications that have occurred are; heart failure (51.7%), systemic embolization (51.7%), pulmonary embolism (31%) and septic shock (15.5%). Overall mortality rate during index hospitalization was 34.5 %. Significant renal involvement was found to be strong predictor for in-hospital mortality (p <0.001)