Diagnostic value of indirect pancreatic function test in serum of anuric patients with chronic renal failure

Abstract

Although patients with chronic renal failure have a high incidence of chronic pancreatic disease, the condition is frequently overlooked. We have modified the pancreolauryl test--an indirect pancreatic function test--for anuric patients. The test permitted good discrimination between patients with chronic pancreatic disease and those with a normal pancreas when serum levels of fluorescein were measured 10 h after administration with a standard meal. The sensitivity at this time interval was 80% and the specificity 83%. We conclude that the pancreolauryl test with serum measurements provides a simple, noninvasive, and reliable diagnostic test for chronic pancreatic disease in anuric patients with chronic renal failure.

Diagnostic workup of patients with pancreatic diseases

“…Before performing this pancreatic function test oral enzyme supplementation must be discontinued as orally taken enzymes also cleave the substrate and can thus falsely indicate normal pancreatic function. The pancreolauryl test can also quantify severe exocrine insufficiency via a diminished increase in serum fluorescein or in hemofiltration fluid from patients with renal insufficiency and on renal replacement therapy [48]. The sensitivity is 82% with a specificity of 91% for severe exocrine insufficiency.…”