Características y valor pronóstico del fracaso renal agudo en la pancreatitis aguda grave

Gutiérrez, Manuel Elías; Pérez, Gemma Seller; gracia, C. De la rubia de; Sanchez, M; López, Belén Nacle

doi:10.1016/s0025-7753(00)71674-5

Cited by 26 publications

(6 citation statements)

References 39 publications

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“…A similar result was reported in another study, showing 71.2% mortality versus 6.8% in severe acute pancreatitis (SAP) patients with and without AKI [21]. Our study found the severity of pancreatitis in the AKI group was significantly higher than in the non-AKI group on admission and there was a 6-fold higher mortality rate (36.5% with AKI versus 5.8% without AKI) in AP patients, which suggests that SAP itself is associated with higher incidence of AKI, and that both SAP and AKI may be the factors that increased patients’ mortality risk.…”

Section: Discussionsupporting

confidence: 88%

Procalcitonin Levels Predict Acute Kidney Injury and Prognosis in Acute Pancreatitis: A Prospective Study

et al. 2013

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BackgroundAcute kidney injury (AKI) has been proposed as a leading cause of mortality for acute pancreatitis (AP) patients admitted to the intensive care unit (ICU). This study investigated the predictive value of procalcitonin (PCT) for AKI development and relevant prognosis in patients with AP, and compared PCT’s predictive power with that of other inflammation-related variables.MethodsBetween January 2011 and March 2013, we enrolled 305 cases with acute pancreatitis admitted to ICU. Serum levels of PCT, serum amyloid A (SAA), interleukin-6 (IL-6), and C reactive protein (CRP) were determined on admission. Serum PCT was tested in patients who developed AKI on the day of AKI occurrence and on either day 28 after occurrence (for survivors) or on the day of death (for those who died within 28 days).ResultsSerum PCT levels were 100-fold higher in the AKI group than in the non-AKI group on the day of ICU admission (p<0.05). The area under the receiver-operating characteristic (ROC) curve of PCT for predicting AKI was 0.986, which was superior to SAA, CRP, and IL-6 (p<0.05). ROC analysis revealed all variables tested had lower predictive performance for AKI prognosis. The average serum PCT level on day 28 (2.67 (0.89, 7.99) ng/ml) was significantly (p<0.0001) lower than on the day of AKI occurrence (43.71 (19.24,65.69) ng/ml) in survivors, but the serum PCT level on death (63.73 (34.22,94.30) ng/ml) was higher than on the day of AKI occurrence (37.55 (18.70,74.12) ng/ml) in non-survivors, although there was no significant difference between the two days in the latter group (p = 0.1365).ConclusionSerum PCT is superior to CRP, IL-6, and SAA for predicting the development of AKI in patients with AP, and also can be used for dynamic evaluation of AKI prognosis.

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Section: Discussionsupporting

confidence: 88%

Procalcitonin Levels Predict Acute Kidney Injury and Prognosis in Acute Pancreatitis: A Prospective Study

et al. 2013

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“…Acute renal failure (ARF) in the setting of AP has been shown to have a 10-fold increase in mortality (74.7% versus 7%) in a study of 563 patients (6). A similar result was reported in another study, showing 71.2% mortality versus 6.8% in SAP patients with or without ARF (7). In agreement with the above studies, a recent cross-sectional study reported a 5-fold increase (66.6% with ARF versus 14.5% without ARF) in mortality in SAP patients, providing an updated assessment of the clinical standpoint (8).…”

Section: Introductionsupporting

confidence: 90%

Acute renal failure in severe pancreatitis: A population-based study

Lin

Lai

et al. 2011

Upsala Journal of Medical Sciences

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IntroductionAcute pancreatitis (AP) is a common illness with varied mortality and morbidity. Patients with AP complicated with acute renal failure (ARF) have higher mortality than patients with AP alone. Although ARF has been proposed as a leading mortality cause for AP patients admitted to the ICU, few studies have directly analyzed the relationship between AP and ARF.MethodsWe performed a retrospective study using the population-based database from the Taiwan National Health Insurance Research Database (NHIRD). In the period from 1 January 2005 to 31 December 2005, every patient with AP admitted to the ICU was included and assessed for the presence of ARF and mortality risk.ResultsIn year 2005, there were a total of 221,101 admissions to the ICU. There were 1,734 patients with AP, of which 261 (15.05%) patients also had a diagnosis of ARF. Compared to sepsis and other critical illness, patients with AP had a higher risk of having a diagnosis of ARF, and patients with both diagnoses had a higher mortality rate in the same ICU hospitalization.ConclusionAP is associated with a higher risk of ARF, and, when both conditions exist, a higher risk of mortality is present.

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“…Prior studies have reported the clinical outcomes including hospital stay and mortality for SAP patients who developed acute RF[ 6 , 7 , 9 , 10 ]. Comparison across those studies has been difficult due to heterogeneity of the patient populations, varying definitions of acute RF and AP severity, and different end-points.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis

Gougol

Dugum

Dudekula

et al. 2017

WJG

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AIMTo assess differences in clinical outcomes of isolated renal failure (RF) compared to other forms of organ failure (OF) in patients with severe acute pancreatitis (SAP).METHODSUsing a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ (2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ2 test for discrete variables.RESULTSAmong 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75 (67.6%) were male. Forty-three patients had isolated OF: 17 (15.3%) renal, 25 (21.6%) respiratory, and 1 (0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support (76.5% vs 96%, P = 0.001), ICU admission (58.8% vs 100%, P = 0.001), and had shorter mean ICU stay (2.4 d vs 15.7 d, P < 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died.CONCLUSIONAmong patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.

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Características y valor pronóstico del fracaso renal agudo en la pancreatitis aguda grave

Cited by 26 publications

References 39 publications

Procalcitonin Levels Predict Acute Kidney Injury and Prognosis in Acute Pancreatitis: A Prospective Study

Procalcitonin Levels Predict Acute Kidney Injury and Prognosis in Acute Pancreatitis: A Prospective Study

Acute renal failure in severe pancreatitis: A population-based study

Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis

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