Acute pancreatitis: Trends in outcomes and the role of acute kidney injury in mortality- A propensity-matched analysis

Devani, Kalpit; Charilaou, Paris; Radadiya, Dhruvil; Brahmbhatt, Bhaumik; Young, Mark; Reddy, Chakradhar

doi:10.1016/j.pan.2018.10.002

Cited by 54 publications

(52 citation statements)

References 32 publications

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“…Acute kidney injury is a well-known complication of acute pancreatitis. It occurs in almost 70% of cases of severe acute pancreatitis [3].The development of acute kidney injury in patients with severe acute pancreatitis significantly increases the risk of hospital mortality [3,19,20] and carries a very poor prognosis [21,22]. In recent years, blood purification treatment plays a significant role in the comprehensive treatment of acute pancreatitis [23,24].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a predictive model for predicting acute kidney injury in patients with acute pancreatitis

Yang¹,

Kang²,

Wen³

et al. 2020

Preprint

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Background: Acute kidney injury is a serious complication of acute pancreatitis and significantly increases the risk of mortality. Early identification of acute kidney injury is important for medical interventions and care options. The aim of this study is to develop a predictive model that could rapidly identify high-risk population of acute kidney injury in patients with acute pancreatitis. Methods: Totally 808 patients with acute pancreatitis admitted to our center from January 2015 to May 2019 were included in the study and were divided into the training (n =566) and validation (n = 242) cohorts randomly, in a 2:1 ratio. The least absolute shrinkage and selection operator (LASSO) regression was used for data dimension reduction and feature selection; then, multivariable logistic regression analysis was used to develop the prediction model. The performance of this nomogram was evaluated with calibration and validated in the validation set. Decision curve analysis was applied to evaluate the clinical usefulness of this model. Results: Five potential predictors (BMI, RANSON score, serum uric acid, triglycerides and lactate) from 53 high‑dimensional clinical variables were incorporated to develop the prediction model of acute kidney injury. The nomogram demonstrated valuable prediction performance with AUROC of 0.994 and 0.996 in the training and validation cohorts, respectively. Individual risk probability was visually scored. The nomogram achieved fine calibration and good clinical usefulness. Conclusions: The proposed nomogram can help to identify high-risk population of acute kidney injury in patients with acute pancreatitis and facilitate timely individualized clinical decision‑making. Keywords: acute kidney injury; acute pancreatitis; risk factor; nomogram

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Section: Discussionmentioning

confidence: 99%

Development and validation of a predictive model for predicting acute kidney injury in patients with acute pancreatitis

Yang¹,

Kang²,

Wen³

et al. 2020

Preprint

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“…Overall prevalence of AKI is 7.9% among in hospitalized patients with AP. 3 The mortality rate among AKI subgroup was significantly higher (8.8% in AKI group vs 0.7% in non-AKI). Despite the availability of intensive care, AKI is one of the most common causes of death in patients with SAP.…”

Section: Introductionmentioning

confidence: 88%

“…Despite the availability of intensive care, AKI is one of the most common causes of death in patients with SAP. 3 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum Cystatin C as an Early Biomarker of Acute Kidney Injury in Patients with Acute Pancreatitis

Patel

Shyam

Bharti

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Introduction Acute pancreatitis (AP) is an inflammatory process of pancreas with varying degree of involvement of regional tissues. The aim of this study was to investigate the potential use of serum cystatin C (Cys-C) for the early and accurate diagnosis of acute kidney injury (AKI) in patients of AP. Materials and methods This was a prospective study conducted in 1 year. Total of 215 cases of AP fulfilling the inclusion criteria were enrolled in this study. Patients suffering from chronic pancreatitis, neoplasm, chronic liver disease, and chronic kidney disease were excluded from the study. Diagnosis of AP was based on the Atlanta classification 2012. All patients were classified into a non-AKI group ( n = 152) and an AKI group ( n = 38) according to the dynamic changes in serum creatinine levels. Serum Cys-C was measured by particle-enhanced immune nephelometric assay. Results By univariate logistic regression analysis, body mass index (BMI) (OR = 1.44, 95% CI: 1.23–1.68; p < 0.001), blood urea (OR = 1.15, 95% CI: 1.06–1.23; p < 0.001), Cys-C (OR = 1.04, 95% CI: 1.01–1.07; p < 0.05), serum calcium (OR = 0.59, 95% CI: 0.41–0.86; p < 0.05), and serum lactate dehydrogenase (LDH) (OR = 1.001, 95% CI: 1.0–1.001; p < 0.05) were the significant indicators for AKI in patients with AP. Using multivariate logistic regression analysis, urinary albumin and Cys-C were independent and significant indicators of AKI in patients with AP (OR = 1.026, 95% CI: 1.01–1.07; p < 0.01). Receiver operating characteristic (ROC) curve of serum Cys-C, for AKI in patient with AP could be identified with a sensitivity of 92.06% at specificity of 96.0% [area under the curve (AUC) = 0.96, 95% CI: 0.92–0.98] by baseline serum Cys-C (cutoff value = >32.32 mg/L). Conclusion Increase of baseline serum Cys-C was associated with AKI in patients with AP. How to cite this article Patel ML, Shyam R, Bharti H, Sachan R, Gupta KK, Parihar A. Evaluation of Serum Cystatin C as an Early Biomarker of Acute Kidney Injury in Patients with Acute Pancreatitis. Indian J Crit Care Med 2020;24(9):777–782.

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“…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].…”

Section: Introductionmentioning

confidence: 93%

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

Gori

Pierini

Lippi

et al. 2020

Veterinary Sciences

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Symmetric dimethylarginine (SDMA) is considered an important biomarker of kidney dysfunction. The aims of the study were to evaluate SDMA in dogs with acute pancreatitis (AP) and its relationship with the presence of kidney injury and mortality. A cohort study including fifty-four dogs with AP diagnosed using compatible clinical and laboratory parameters, abnormal SNAP cPL and compatible abdominal ultrasound within 48 h from admission, was conducted. Dogs with history of renal and/or urinary diseases were excluded, along with dogs exposed to nephrotoxic drugs. Serum urea and creatinine and urinary output (UO) were recorded. Acute kidney injury (AKI) was diagnosed and graded using International Renal Interest Society (IRIS) guidelines. SDMA was measured using high performance liquid chromatography. Fifty-four dogs were included and divided in non-AKI (n = 37) and AKI dogs (n = 17). Twenty-three dogs (14 non-AKI) had SDMA > 15 μg/dL. Median SDMA was higher in AKI dogs than non-AKI dogs (25.7 vs. 13.93 μg/dL; p = 0.03). Dogs with normal creatinine (AP and AKI 1 dogs) had SDMA above reference range in 38% and 33% of cases, respectively. In AKI dogs, SDMA and creatinine were positively correlated (p = 0.006 r = 0.7). SDMA was not significantly different between survivors and non-survivors. Although further studies are warranted, SDMA may be a useful tool in canine AP, as a high SDMA may be related to subclinical kidney impairment.

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Acute pancreatitis: Trends in outcomes and the role of acute kidney injury in mortality- A propensity-matched analysis

Cited by 54 publications

References 32 publications

Development and validation of a predictive model for predicting acute kidney injury in patients with acute pancreatitis

Development and validation of a predictive model for predicting acute kidney injury in patients with acute pancreatitis

Evaluation of Serum Cystatin C as an Early Biomarker of Acute Kidney Injury in Patients with Acute Pancreatitis

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

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