Introduction:
Acute kidney injury (AKI) is one of the serious complications in patients with severe acute pancreatitis (SAP). Severe acute pancreatitis is associated with a higher incidence of mortality ranging from 7% to 47%. A tenfold increase in mortality has been shown to be observed in acute pancreatitis associated with acute renal failure.
Methods:
This is a retrospective study of 120 patients, who were admitted in Gandhi Medical College with severe acute pancreatitis diagnosed based on the Revised Atlanta classification (2012).Patients with severe acute pancreatitis and AKI were included in the study.The mode of management and the outcome of acute kidney injury were assessed.
Results:
| |
%
|
|
SURVIVORS
|
68
|
|
NON SURVIVORS
|
32
|
|
BISAP SCORE
|
%
|
|
0-2
|
57
|
|
2-4
|
34
|
|
5
|
19
|
| |
|
%(n)
|
|
GENDER
|
Male
|
103
|
|
Female
|
7
|
|
|
AGE
|
21-30
|
14
|
|
31-40
|
38
|
|
|
41-50
|
53
|
|
|
51-60
|
8
|
|
|
>60
|
7
|
|
|
COMORBID CONDITION
|
DIABETES
|
42%
|
|
HYPERTENSION
|
33%
|
|
|
PRESENTATION
|
|
|
|
PAIN ABDOMEN
|
92%
|
|
|
VOMITINGS
|
79%
|
|
|
FEVER
|
35%
|
|
|
OLIGURIA
|
57%
|
|
|
BREATHLESNESS
|
38%
|
|
|
POSSIBLE ETIOLOGY
|
|
|
|
ALCOHOL INTAKE
|
89%
|
|
|
GALL STONES
|
6%
|
|
|
HYPERTRIGLYCERIDEMA
|
32%
|
|
| |
|
Mean Hemoglobin(g/dl)
|
8.31 ±1.69
|
|
Mean WBC
|
17160 ± 8763
|
|
Mean Platelet
|
2.71 ± 1.04
|
|
Mean Blood Urea Nitrogen(mg/dl)
|
137.51 ± 54.86
|
|
Mean Creatinine (mg/dl)
|
6.63± 2.57
|
|
Mean albumin (g/dl)
|
3.29 ± 1.79
|
|
Mean AST
|
3.86± 36.32
|
|
Mean ALT
|
3.51± 32.79
|
|
Mean Calcium
|
8.2 ± 3.4
|
|
Mean Total cholesterol
|
247.5± 125.1
|
|
Mean triglycerides
|
412.76 ± 124.78
|
|
Mean serum lipase
|
737.63 ± 302.65
|
|
Mean serum amylase
|
962.84 ± 940.89
|
|
| |
%
|
|
AKI STAGE 1
|
12
|
|
AKI STAGE 2
|
20
|
|
AKI STAGE 3
|
68
|
|
BISAP SCORE
|
%
|
|
0-2
|
57
|
|
2-4
|
34
|
|
5
|
19
|
|
MODE OF RRT
|
%
|
|
HAEMODIALYSIS
|
60
|
|
CRRT
|
15
|
| |
%
|
|
PARTIAL RECOVERY
|
22
|
|
COMPLETE RECOVERY
|
40
|
| |
SURVIVORS(62)
|
NON SURVIVORS(38)
|
p value*
|
|
MALE
|
62
|
30
|
0.415
|
|
FEMALE
|
6
|
2
|
0.331
|
|
Mean Hemoglobin(g/dl)
|
8.15±1.52
|
8.09 ±1.80
|
0.018
|
|
Mean WBC
|
17236 ± 8403
|
18726 ± 9443
|
0.541
|
|
Mean Platelet
|
2.78 ± 1.84
|
2.71 ± 1.72
|
0.443
|
|
Mean Blood Urea Nitrogen(mg/dl)
|
148 ± 44.79
|
143.31 ± 41.99
|
0.011
|
|
Mean Creatinine (mg/dl)
|
6.01± 2.32
|
6.63± 1.72
|
0.342
|
|
Mean albumin (g/dl)
|
3.64 ± 1.76
|
3.42± 1.42
|
0.412
|
|
Mean AST
|
35.82± 33.78
|
38.74± 34.72
|
0.318
|
|
Mean ALT
|
33.89± 30.29
|
34.88± 32.76
|
0.220
|
|
Mean Calcium
|
8.3± 3.2
|
8.24± 3.27
|
0.028
|
|
Mean Total cholesterol
|
232.5± 133.1
|
237.7± 124.7
|
0.231
|
|
Mean triglycerides
|
448.75 ±131.54
|
448.54 ± 134.29
|
0.138
|
|
Serum Lipase
|
433± 216.74
|
627.61± 324.87
|
0.039
|
|
Mean serum amylase
|
554.98 ± 332.34
|
591.21 ± 314.13
|
|
|
Gall stones
|
4
|
2
|
0.640
|
|
AKI stage 3
|
30
|
39
|
0.030
|
|
Hemodialysis
|
34
|
26
|
0.031
|
|
CRRT
|
9
|
6
|
0.003
|
|
Multi organ failure
|
7
|
38
|
0.002
|
Conclusions:
1. Mean age of patients was 41.72±13.40 years.
2. Alcohol intake was precipitating factor in 87% patients and gall stones were present in 8%.
3. Diabetes was present in 44% of the patients.
4. AKI stage 1 was seen in 12%, stage 2 in 20%,stage 3 in 68% .
5. CRRT was done in 15 patients.
6. BISAP score more than 3 was observed in 40%.
7. Mortality was 34%.
8. Factors influencing mortality were serum lipase 3 times elevation, high BUN at admission,AKI stage 3 at admission and multi organ dysfunction(p< 0.05).
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.