Renal clearance of amylase during pancreatitis

Mulhausen, Robert; Brown, David C.; Onstad, Gerald R.

doi:10.1016/0026-0495(69)90080-8

Cited by 30 publications

(7 citation statements)

References 19 publications

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“…Mulhausen et al (19) and Levitt et al (16) underlined the changes in Cam/Ccr during AP: the mean Cam/Ccr values calculated on the basis of the results obtained from 23 and 12 cases, reach 6.6 ± SEM 0.3% and 6.8 ± SD 2.6%, respectively, whereas they reached 16 ± SEM 3.8% in our survey. How can this difference be accounted for?…”

Section: Discussioncontrasting

confidence: 44%

“…(1). According to Levitt et al (15), the amylase dosing technique, whether saccharogenic or iodometric, cannot explain it; (2) Mulhausen et al (19) and Levitt et al (16) Nevertheless, the overall results recorded confer upon this test an undeni able importance in the diagnosis of acute abdominal complaints, with or without hyperamylasemia. A moderate increase of Cam /Ccr can effectively be observed in medical or surgical diseases, other than AP; however, a very high ratio (>7.8%) seems to be more specific of the latter.…”

Section: Discussionmentioning

confidence: 99%

“…In tire wake of work done by Delcourt and Wettendorff (7) and Blainey and Northam (4), several authors (16,17,19) have underlined the importance of determining amylase clearance in relation to creatinin clearance (Cam/Ccr). For Wars haw and Fuller (24) and Lesser and Warsliaw (13), this test enabled hyperamylasemia to be linked more easily to AP.…”

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confidence: 99%

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Increase in Amylase Clearance in Relation to Creatinin Clearance during Acute Pancreatitis

Hostein¹,

Fournet²,

Létoublon³

et al. 1978

Digestion

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Renal amylase clearance in relation to creatinin clearance (C_am/C_cr) was determined for 20 patients suffering from acute pancreatitis (AP). For each of them, the diagnosis rested upon operative or laparoscopic observation of characteristic anatomical or histological lesions. The average clearance relationship in these patients reached 16 ± SEM 3.8%. These results were significantly higher than those obtained from 132 patients who had been hospitalized for other medical or surgical diseases, as well as from 51 test patients (p < 0.001). The authors stressed the diagnostic importance of this test, in particular in the presence of a normal amylasemia level.

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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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Increase in Amylase Clearance in Relation to Creatinin Clearance during Acute Pancreatitis

Hostein¹,

Fournet²,

Létoublon³

et al. 1978

Digestion

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“…It is known that CAm increases during acute pancreatitis (27,47), and the rate of urinary amylase excretion is therefore disproportionately elevated relative to the serum level. The present studies rule out the possibility that this increased CAm results from a saturation of a tubular reabsorption mechanism for amylase.…”

Section: Discussionmentioning

confidence: 99%

Distribution, turnover, and mechanism of renal excretion of amylase in the baboon

Duane

Frerichs²,

Levitt

1971

J. Clin. Invest.

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A B S T R A C T Pure amylase was isolated from pancreata and parotid glands of the baboon, an animal which has a serum amylase level and renal clearance of amylase (CAm) similar to man. After bolus injection, both pancreatic and salivary amylase rapidly disappeared from the serum in a monoexponential fashion with a mean serum half-time of approximately 83 min. Only about 24% of the amylase cleared from the serum appeared in the urine indicating that the majority of amylase was removed from the serum by an extraurinary mechanism. The CA. by the kidney was constant over a wide range of serum amylase levels and the ratio of CAm/CI, which averaged 3.0%, was not influenced by mannitol diuresis. This suggests that the renal excretion of amylase results from glomerular filtration without appreciable tubular reabsorption. Pancreatic amylase was consistently cleared more rapidly by the kidney than was the baboon's endogenous amylase while salivary amylase was consistently cleared less rapidly than endogenous amylase.The findings in this study provide insight into several of the following clinically observed phenomena: (a) the short serum half-time of atpylase accounts for the transient nature of serum amylase elevations in pancreatitis; (b) the extra-urinary removal of amylase accounts for the maintenance of relatively normal amylase levels in uremia; and (c) the more rapid renal clearance of pancreatic amylase compared to salivary amylase may explain the disproportionate elevation of the urinary amylase excretion rate relative to the serum amylase level in acute pancreatitis.

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“…Therefore, hyperamylasemia is often ob served in case of renal failure (16,19,21], and the renal clearance of amylase varies in close association with the creatinine clear ance [3,22], The amylase to creatinine clear ance ratio (ACCR) has been claimed to be a convenient index of the renal handling of…”

mentioning

confidence: 99%

Kidney Ageing and Renal Excretion of Amylase

Brohée¹,

Rondelez²,

Bain³

et al. 1982

Gerontology

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In a cross-sectional study, the amylase to creatinine clearance ratio (ACCR) was determined in 180 patients, age range 18–93 years. An inverse correlation was found between ACCR and creatinine clearance (r = ––0.40, p < 0.001) in keeping with the known inverse relationship between the sieving fraction of macromolecules and the glomerular filtration rate. The fractional clearance of amylase was not significantly affected by amylasemia nor by age when the creatinine clearance was also considered in a multiple regression analysis. No increase in ACCR was observed in patients with low molecular weight proteinuria or with induced urine dilution. The authors assume that the tubular reabsorption of amylase is minimal and that the enhancement of ACCR in the elderly mainly reflects modifications in the glomerular filtration dynamics.

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Renal clearance of amylase during pancreatitis

Cited by 30 publications

References 19 publications

Increase in Amylase Clearance in Relation to Creatinin Clearance during Acute Pancreatitis

Increase in Amylase Clearance in Relation to Creatinin Clearance during Acute Pancreatitis

Distribution, turnover, and mechanism of renal excretion of amylase in the baboon

Kidney Ageing and Renal Excretion of Amylase

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