Pancreatitis: An Important Cause of Abdominal Symptoms in Patients on Peritoneal Dialysis

Caruana, Ralph J.; Wolfman, Neil T.; Karstaedt, Nolan; Wilson, Daniel J.

doi:10.1016/s0272-6386(86)80134-2

Cited by 53 publications

(38 citation statements)

References 12 publications

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“…Our previous work suggested that acute pancreatitis was more common in CAPD than in hemodialysis patients [9], but the present study does not support the hypothe sis that CAPD is more likely to be associated with subclinical pancreatic disease manifested only by hyperamy lasemia. The CAPD patients were younger than the hemodialysis patients and had been on dialysis for a shorter length of time, but these factors have not been shown to be correlated with the development of pancre atitis in patients with renal failure.…”

Section: Discussioncontrasting

confidence: 99%

“…Similiar data have not been accumulated on CAPD patients. In a previous report from our dialysis center we showed that pancreatitis was often a cause of abdominal symptoms in our CAPD patients and that serum and peritoneal fluid amylase lev els as well as radiologic studies were useful in estab lishing a diagnosis of pancreatitis in patients presenting with clinical and laboratory findings suggestive of perito nitis [9], We now report the results of a more compre hensive study of the levels of serum and peritoneal fluid amylase in asymptomatic CAPD patients and in those presenting with abdominal symptoms. …”

mentioning

confidence: 68%

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Serum and Peritoneal Fluid Amylase Levels in CAPD

et al. 1987

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The mean serum amylase of 42 asymptomatic CAPD patients was elevated but was not significantly different from that of a group of chronic hemodialysis patients. Serum amylase levels in CAPD patients with peritonitis were not elevated with respect to asymptomatic patients. Amylase activity was not detectable in the peritoneal fluid of 38/42 asymptomatic patients and 6/13 peritonitis patients and was present at low levels in the other 11 patients. Patients with other abdominal conditions (pancreatitis, cholecystitis and small bowel perforation) had very marked elevations of serum and/or peritoneal fluid amylase which differentiated them from the asymptomatic and peritonitis patients. Although hyperamylasemia is common in asymptomatic CAPD patients and in those with peritonitis, measurement of serum and peritoneal fluid amylase levels is useful in the evaluation of CAPD patients presenting with abdominal symptoms.

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Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 68%

Serum and Peritoneal Fluid Amylase Levels in CAPD

et al. 1987

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“…It has been emphasized that pancreatitis is an impor tant cause of abdominal symptoms in patients on perito neal dialysis [1], However, tests commonly used to eval uate pancreatic disease, including serum total amylase, pancreatic amylase, lipase and immunoreactive trypsin are frequently increased in chronic renal failure (CRF) even in the absence of pancreatitis. The percentage of pancreatic amylase in scrum (pancreatic/total amylase) has been reported to be useful in supporting the diagno sis of acute pancreatitis in patients with CRF [2], Despite considerable literature on serum total and pancreatic amylase activités in CRF and regular hemodi alysis (HD) patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15], there are no published stud ies of amylases in patients supported with peritoneal dialysis (PD).…”

Section: Introductionmentioning

confidence: 99%

Serum Amylases in Chronic and End-Stage Renal Failure: Effects of Mode of Therapy, Race, Diabetes and Peritonitis

Bastani

Mifflin²,

Lovell³

et al. 1987

Am J Nephrol

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Serum total amylase, pancreatic amylase and lipase activities were studied prospectively in 43 hemodialysis, 22 peritoneal dialysis and 22 chronic renal failure patients. None of the patients had symptoms of pancreatic disease at the time of study. Mean total amylase activities were similar and above the upper limit of normal in the 3 treatment groups. Total amylase was abnormal in 75% of the patients and exceeded twice the upper limit of normal in 24%. Blacks and nondiabetics had higher levels than whites and diabetic patients, respectively. Percentage pancreatic amylase exceeded the upper limits of normal in one third of the patients. Mean pancreatic amylase was above the upper normal limit in the 3 groups, and values were abnormal in 63% of all patients. Mean pancreatic amylase activity was significantly lower in peritoneal dialysis than in hemodialysis or chronic renal failure patients (p = 0.01). Pancreatic amylase activity was unaffected by race. The higher total amylase activity in blacks was due to increased salivary isoenzyme. Hemodialysis treatments did not change total amylase or pancreatic amylase activity. Mean lipase activity approximated the upper limit of normal in the 3 groups and values were abnormal in 42 % of all patients. Serum total amylase and pancreatic amylase activity did not increase during episodes of peritonitis in the peritoneal dialysis group. Peritoneal dialysis, whether or not accompanied by peritonitis, was responsible for removal of only a small amount of amylase activity per day. The results indicate that reference values for serum amylases must be adjusted not only for the presence of chronic renal failure, but also for the type of therapy employed, the patients’ race and the presence or absence of diabetes.

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“…716 son dönem böbrek yetmezlikli hastayı içeren bir takipte ise 46 hastada (%6,4) pankreatit geliştiği raporlanmıştır 3 . Periton diyalizi gö-ren hastalarda ise hemodiyaliz hastalarına göre daha yüksek pankreatit prevelansı bildirilmiştir 4 . Son dönem böbrek yetmezliği olan hastalarda akut ve kronik pankreatit etyolojisinde renal yetmezlik olmayanlara göre belirgin fark bulunmamaktadır.…”

Section: Discussionunclassified