[Clinical implications of renal affection among systemic manifestations of infectious endocarditis].

AIM: To assess the importance of renal affection and other systemic manifestations of infectious endocarditis (IE) among factors of unfavourable IE prognosis. MATERIAL AND METHODS: The examination including bacteriological blood test, transthoracic echocardiography was made in 54 patients with IE (35 males and 19 females aged 17-75 years). Transesophageal echocardiography and coagulogram examination were additionally performed in 11 and 45 patients, respectively. RESULTS: Modern methods of statistic processing were employed to study systemic IE manifestations. Among them, prognostically significant were singled out and analysed including renal affection. Clinical variants of renal affection were determined in IE patients and their characteristics were determined: high incidence and severity of erythrocyturia, rare occurrence of arterial hypertension, frequent episodes of acute renal failure. A close correlation is shown between IE-associated renal affection, DIC symptoms and thrombocytopenia. Signs of renal damage in IE patients raise probability of other systemic manifestations including prognostically significant ones. This allows one to consider renal affection as a marker of an unfavourable IE course. CONCLUSION: A complex of significant factors of IE unfavorable outcome is determined including such systemic manifestations as severe renal affection, thromboembolism, splenomegaly. These factors are of importance in deciding on surgical intervention--valve replacement.