IDENTIFYING PREDICTORS OF ACUTE KIDNEY INJURY IN ACUTE PANCREATITIS: INSIGHTS FROM A RETROSPECTIVE OBSERVATIONAL STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/1b7c06186c074cab25726fd4f2dc58c3.pdf
IDENTIFYING PREDICTORS OF ACUTE KIDNEY INJURY IN ACUTE PANCREATITIS: INSIGHTS FROM A RETROSPECTIVE OBSERVATIONAL STUDY

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Vishnu
Balaji
Vishnu Balaji kvishnubalajii@gmail.com MS RAMAIAH MEDICAL COLLEGE Department of Nephrology Bengaluru India *
Mahesh E manasnephro2002@yahoo.co.in MS RAMAIAH MEDICAL COLLEGE Department of Nephrology Bengaluru India -
Gireesh M S gireesh_ms@yahoo.com MS RAMAIAH MEDICAL COLLEGE Department of Nephrology Bengaluru India -
Mohammad Yousuff dr.mohammadyousuff@gmail.com MS RAMAIAH MEDICAL COLLEGE Department of Nephrology Bengaluru India -
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Acute kidney injury (AKI) is a frequent and serious complication in patients with acute pancreatitis (AP), contributing significantly to morbidity and mortality. The incidence of AKI in AP varies across studies due to differences in disease severity. The underlying pathophysiology is multifactorial, involving early intravascular volume depletion followed by complex inflammatory, vascular, and humoral mechanisms that precipitate renal dysfunction. Early identification of patients at risk for AKI is essential for timely intervention and improved outcomes. This study aimed to identify clinical predictors of AKI among patients with acute pancreatitis.

This retrospective observational study included 308 adult patients (18 years and above) diagnosed with AP, admitted to M. S. Ramaiah group of hospitals and medical college, Bengaluru, India, over the period of 6 years i.e. 2018-2024, excluding individuals who had underlying chronic pancreatitis, chronic kidney disease (CKD) and post surgical pancreatitis, trauma, inflammatory bowel disease, were excluded from our study. Patients were diagnosed to have Acute pancreatitis based on the Revised Atlanta classification- 2012. Patients with AKI were identified based on the KDIGO-AKI-2012 guidelines. Data was collected on age, sex, co-morbidities, substance use, treatment history, pulse, blood pressure, urine output, serum amylase, serum lipase, serum creatinine and need for renal replacement therapy. Bivariate analysis was performed to identify variables associated with AKI, followed by multivariate logistic regression to determine independent predictors.

Among the 308 patients, 77 (25.0%) developed AKI, out of which 29 required hemodialysis and 19 mortalities were associated with AKI. On bivariate analysis, AKI was significantly associated with age >50 years (p = 0.007), diabetes mellitus (p = 0.003), hypertension (p < 0.001), low blood pressure (p < 0.001), oliguria (p<0.001), sepsis (p < 0.001), and mortality (p < 0.001). Multivariate logistic regression identified hypertension as a prior co-morbidity  (p = 0.035) and oliguria at presentation (p < 0.001) as independent predictors of AKI.

AKI occurs in a substantial proportion of patients with acute pancreatitis and is associated with higher mortality. Hypertension and oliguria at presentation are strong independent predictors of AKI, underscoring the importance of early recognition and close monitoring in this high-risk group.

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