Pleural Effusion Is Associated with Severe Renal Dysfunction in Patients with Acute Pancreatitis

Abstract

Background Renal dysfunction is a leading cause of death in patients with acute pancreatitis (AP) and often occurs later than respiratory complications. Whether respiratory complications can predict renal impairment remains unclear. The aim of this study was to investigate the association between pleural effusion and renal dysfunction in AP. Material/Methods Medical records were reviewed from individuals who were hospitalized with AP from January 1, 2015 to December 31, 2019. The patients were divided into 2 groups, based on the presence or absence of pleural effusion on admission. Disease severity, renal function parameters, and outcomes were compared between the 2 groups. Results A total of 222 patients were enrolled, 25 of whom had pleural effusion on admission and 197 who did not. Patients with AP who had pleural effusion had more serious illness (higher incidences of pancreatic inflammation, pancreatic fluid collection, and moderate-to-severe AP; worse Bedside Index for Severity in Acute Pancreatitis score; and a higher modified computed tomography severity index [all P <0.05]) plus worse outcomes (higher incidences of ventilation and vasopressor use [both P <0.05]). Moreover, patients with pleural effusion had a higher level of blood urea nitrogen and lower estimated glomerular filtration rate (both P <0.05). After adjustment for potential confounders, pleural effusion was a risk factor for renal failure in patients with AP (odds ratio 6.32, 95% confidence interval 1.08–36.78, P =0.040). Conclusions Pleural effusion is associated with severe renal dysfunction in AP. Therefore, efforts should be made to improve early recognition and timely treatment of renal failure by closely monitoring renal function in patients with AP and pleural effusion on admission.

Effects of Indwelling Pleural Catheter on Severe Acute Pancreatitis: A Retrospective Study

“…This study showed that SAP patients with PE rather without PE were more serious and had worse outcome, which was consistent with the previous studies [ 8 , 9 , 23 ]. In addition, this study also drew the same results as before: PE was a risk factor for death, but not an independent risk factor for death of SAP [ 24 ].…”

“…Recent report suggests that the incidence of PE in AP is up to 50% [ 8 ]. Besides, PE is a good predictor for SAP and even better than Ranson score and Acute Physiology and Chronic Health Evaluation II (APCHE II) score in reflecting the severity of SAP [ 8 , 9 ]. Indwelling pleural catheter (IPC) is effective for benign and malignant PE and could improve living quality of patients by intermittently relieving PE symptoms [ 10 , 11 ].…”

What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?

“…While renal failure is comprehensively addressed in the EuroSCORE system so that an outcome-prediction can be made, frailty itself remains elusive as only age alone is visible as a risk factor. Thus, not only a high BMI can be considered a risk factor, but also an unintentional BMI decline indicating frailty and thus the risk for an adverse outcome [ 23 , 24 ]. Therefore, in addition to the EuroSCORE, an assessment of frailty is needed to make an informed recommendation for surgical or interventional therapy in these patients on an individual basis, especially for demanding procedures with inherent risks such as mitral valve surgery.…”

Incidence and prognostic role of pleural effusion in patients with acute pancreatitis: a meta-analysis

“…Additionally, PE was detected by chest X-ray in eight studies [ 16 , 18 , 20 , 22–24 , 41 , 50 ], by CT in 14 studies [ 19 , 21 , 25–27 , 30 , 32 , 35 , 38 , 39 , 42 , 45–47 ], by transthoracic sonography in one study [ 17 ] and by combination of above methods in four studies [ 29 , 31 , 48 , 49 ]. Other studies did not clearly report the detecting method [ 28 , 33 , 34 , 36 , 37 , 40 , 43 , 44 ]. The general characteristics of the eligible studies are shown in Table 1 .…”