The Incidence and Clinical Course of Acute Renal Failure in Patients with Severe Acute Pancreatitis.
- Author:
Su Lim LEE
1
;
Hyun Gyung KIM
;
Byung Soo KIM
;
Ho Cheol SONG
;
Bong Koo KANG
;
Hyuk Min KWON
;
Eui Sung CHUNG
;
Hye Eun YOON
;
Young Soo KIM
;
Sung Soo KIM
;
Sun Ae YOON
;
Min Gul KIM
;
Young Ok KIM
Author Information
1. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Acute renal failure;
Pancreatitis
- MeSH:
Acute Kidney Injury;
APACHE;
Creatinine;
Dyspnea;
Humans;
Incidence;
Korea;
Medical Records;
Multivariate Analysis;
Pancreatitis;
Renal Dialysis;
Respiratory Insufficiency;
Retrospective Studies;
Risk Factors;
Sepsis;
Thrombocytopenia;
Unconsciousness
- From:Korean Journal of Nephrology
2009;28(5):424-432
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Although acute renal failure (ARF) commonly develops in patients with severe acute pancreatitis (SAP), the impact of ARF on disease severity is rarely reported in Korea. This study was performed to compare the clinical findings, morbidity and mortality between SAP patients with and without ARF. METHODS: We retrospectively evaluated the medical records of 102 patients with SAP between january 2001 and June 2008 in 3 hospitals. We investigated the incidence and clinical course of ARF in SAP patients. Then, we compared morbidity and mortality between the patients with ARF and normal renal function (NRF). RESULTS: Of the total 102 SAP patients, ARF was observed in 39 patients (38.2%). The peak serum creatinine level in ARF patients was 4.5+/-2.3 mg/dL. Eight of the 39 ARF patients (20.5%) received hemodialysis and ten patients (25.6%) died. When compared to NRF patiens, ARF patients (n=39) had higher incidence of dyspnea (17.9% vs 3.2%, p=0.011), loss of consciousness (17.9% vs 1.6%, p=0.003), and APACHE II scores more than 8 (92.3% vs 0%, p<0.001). The ARF group had also higher incidences of sepsis (35.9% vs 7.9%, p<0.001), multiorgan failure (15.4% vs 0%, p=0.001), respiratory failure (28.2% vs 4.7%, p=0.001) and mortality (25.6% vs 3.2%, p=0.001). Multivariate analysis demonstrated thrombocytopenia, hemoconcentration, and high LDH as independent risk factors of ARF in SAP patients. CONCLUSION: The incidence of ARF was high (38.2%) and ARF patients showed higher morbidity and mortality, compared to NRF patients. We suggest that early management of ARF should be performed for reducing the mortality in SAP patients.
