Objective To explore the impact of early use of renal replacement therapy on the prognosis of severe acute pancreati-tis patients .Methods 60 cases of patients with severe acute pancreatitis were chosen between September 2015 and June 2016 in De-partment of General Surgery in our hospital ,and were randomly divided into treatment group (n=30) and control group (n=30) with the method of number table .The patients in the control group were treated with conventional therapy ,treatment group was given the early use of renal replacement therapy (within 12 h after onset) .The scores of Acute Physiology and Chronic Health E-valuation Ⅱ (APACHE Ⅱ) ,partial pressure of oxygen (PaO2 ) ,oxygenation index (PaO2/FiO2 ) ,lactate (Lac) ,C-reactive protein (CRP) ,interleukin 1 (IL-1 ) ,and interleukin-6 (IL-6) levels before treatment ,12 h ,24 h ,48 h and 72 h after treatment were com-pared between two groups ,and the incidence of abdominal compartment syndrome (ACS) was compared as well .Results The difference of the indicators before treatment between two groups was not significant different (P>0 .05);the scores of APACHEⅡ ,PaO2 ,PaO2/FiO2 and Lac levels at 12 h ,24 h ,48 h and 72 h after treatment in treatment group were all lower than those in con-trol group ,and the difference was statistically significant (P<0 .05);CRP ,IL-1 and IL-6 levels at 24 h ,48 h and 72 h after treat-ment in treatment group were lower than those in control group ,and the difference was statistically significant (P<0 .05) .In the control group ,5 cases had ACS ,the incidence rate was 16 .7% ,and there was no case having ACS in treatment group and the differ-ence was statistically significant (P<0 .05) .Conclusion The early application of renal replacement therapy can effectively improve the physiological indexes of patients with severe acute pancreatitis ,inhibit the inflammatory response rapidly ,reduce damage to the abdominal organs ,and is worthy of promotion and application in clinical practice .