No abstract

SUMMARY Pancreatic and salivary amylase/creatinine clearance ratios in patients with various degrees of renal impairment were compared with those obtained for control subjects. In chronic renal insufficiency (mean GFR 30 ml/min ± 15 SD; n = 13) the clearance ratios for pancreatic (mean 3X5 + 1X85 SD) and salivary (mean 2.3 + 1-3 SD) amylase were significantly higher (p < 0 05) than those in controls. Corresponding control values (n = 26) were 2-64 + 0-86 (pancreatic) and 1 64 + 0 95 (salivary). Three patients showed values above the normal limit. In the diabetic group (mean GFR 41 ml/min + 22 SD; n = 10) salivary amylase/creatinine clearance ratios (mean 2-36 + 1-55 SD) were significantly higher than in controls (p < 0 05). Three patients showed raised values. Pancreatic amylase clearance was raised in only one of these patients. Three patients with terminal disease (mean GFR 1Oml/min) showed markedly raised (two-to threefold) clearance ratios for both salivary and pancreatic amylase. Of a total of 26 patients, eight had increased total amylase/creatinine clearance ratios. Pancreatic amylase/creatinine clearance was increased in seven patients, while nine patients showed raised salivary amylase/creatinine ratios. Patients with raised clearance ratios did not have clinical evidence of pancreatitis. We suggest that, in the presence of impaired renal function, a high amylase/creatinine clearance ratio need not be indicative of pancreatic disease.