Acute Kidney Injury in association with Acute Pancreatitis

Abstract

Objective:To report case series of patients with acute kidney injury (AKI) developing in association with acute pancreatitis (AP).Methods:All patients coming to Sindh Institute of Urology and Transplantation (SIUT), who developed AKI in association with acute pancreatitis, were included in the study. AKI was defined with sudden rise in creatinine and decline in urine output with normal size kidneys and no previous co morbid. AP defined as patients with abdominal pain and > 3 times rise in serum amylase and /or lipase and radiology suggestive of AP.Results:Between 2000- 2017, 24 patients were found to have AKI in association with AP. Among these 13 were female, mean age was 36.875±10.152 years. Oligoanuria was present in 83%, 46% were icteric on presentation, 42% had circulatory failure, 33% had respiratory failure, 17% had abnormal Glasgow Coma Scale. Renal replacement was required in 79% patients. Complete renal recovery was observed in 54% patients, while 37% died during acute phase of illness. Multi-organ failure showed high prediction of mortality.Conclusion:Being a tertiary renal care unit only patients with renal failure were referred to our hospital, thus exact prevalence of AKI in AP is not known. Multi organ failure (MOF) has shown high mortality in this case series.

Evaluation of Symmetric Dimethylarginine (SDMA) in Dogs with Acute Pancreatitis

“…Briefly, non-survivors show higher prevalence of AKI and oligoanuria (64.7%) and higher median SDMA concentration (16.6 vs 11.67 µg/dL) than survivors ( Table 2). 13.7 (13.4) 3 (33%) 1.1 (0.9) 0 (0%) AP + AKI 2 (n = 3) 16.6 (16.2-50.9) 3 3 (100%) 2.2 (1.7-2.5) 3 3 (100%) AP + AKI 3 (n = 4) 48.9 (47.5) 3 (75%) 3.6 (1.2) 4 (100%) AP + AKI 4 (n = 1) 32 1 (100%) 8.9 1 (100%) 1 Data are displayed as median and interquartile range (IQR) in brackets 2 Data are displayed as absolute and relative frequency. 3 The IQR was not calculated due to the small number of dogs in this group, the values in brackets range from min to max.…”

“…16.6 (16.2-50.9) 3 3 (100%) 2.2 (1.7-2.5) 3 3 (100%) AP + AKI 3 (n = 4) 48.9 (47.5) 3 (75%) 3.6 (1.2) 4 (100%) AP + AKI 4 (n = 1) 32 1 (100%) 8.9 1 (100%) 1 Data are displayed as median and interquartile range (IQR) in brackets 2 Data are displayed as absolute and relative frequency. 3 The IQR was not calculated due to the small number of dogs in this group, the values in brackets range from min to max. Sixteen out of 37 serum samples (43.2%) of survivors were available for the SDMA evaluation at the first recheck (Table 3).…”

“…Table 3. Evaluation of first recheck (T1) SDMA and serum creatinine (sCr) values in AP and AP + AKI dogs, divided into AKI grades (1)(2)(3)(4).…”

“…Sci. 2020, 7, 72 2 of 8 main complication linked to a high morbidity and mortality in AP patients [3][4][5]. The same data have been highlighted also in dogs, where kidney injury was evaluated by three studies [6][7][8].…”

Therapeutic Apheresis in Acute Kidney Injury

“…Mortality is as high as 70-80% [7,17]. This applies to AKI, which develops on the background of severe pancreatitis when 79% of patients have to resort to renal replacement therapy [18]. AKI also often accompanies acute liver failure with high mortality [19].…”