Renal function in experimentally induced acute pancreatitis in dogs: How it is affected by the nephrotoxic substance in pancreatic exudate from ascitic fluid

Abstract

Renal failure occurring in dogs during experimental acute pancreatitis and the effect on renal function of intravenous injections of ascitic fluid which accumulated during the acute pancreatitis were studied. Five hours after the induction of acute pancreatitis, the accumulation of 200 to 400 ml of ascitic fluid, and an elevation in hematocrit as well as a decreased mean arterial pressure were observed, which suggested hypovolemia due to plasma loss. At the same time, the renal blood flow, glomerular filtration rate, and urinary output decreased significantly. Hypovolemia was observed to be the main cause of renal failure in accordance with previous reports. When the sterile ascitic fluid was injected into healthy dogs, temporary hypotension was observed without changes in the hematocrit. However, the renal blood flow, glomerular filtration rate and urinary output decreased, together with an elevation in renal vascular resistance, even after the hypotension had returned to normal. This study shows that renal failure associated with acute pancreatitis occurred mainly as a direct result of hypovolemia but also that the sterile ascitic fluid contained nephrotoxic substances which were suspected to be unrelated to vasoactive substances or protease. Their removal is therefore necessary for the treatment and prevention of renal failure complicating acute pancreatitis.

Significance of apoptotic cell death in systemic complications with severe acute pancreatitis

“…Levy et al 21 concluded that renal failure in acute pancreatitis was only the result of systemic hypovolemia; however Satake et al 22 contradicted this by demonstrating the existence of nephrotoxic substance(s) other than vasoactive substances or proteases.…”

Evaluation of Canine Pancreas‐Specific Lipase Activity, Lipase Activity, and Trypsin‐Like Immunoreactivity in an Experimental Model of Acute Kidney Injury in Dogs

“…Acute kidney injury (AKI) and pancreatitis can lead to similar clinical signs. In addition, these 2 conditions are common comorbidities, as AKI is a well‐documented cause of pancreatitis via ischemia and hypovolemia, and pancreatitis can lead to AKI via hypovolemia and cytokine‐induced ischemia and inflammation . As with other serological biomarkers of pancreatitis, it is plausible that decreased glomerular filtration rate (GFR), as seen with AKI, could result in Spec cPL increase secondary to decreased renal clearance, in the absence of pancreatitis.…”

Pancreatitis-Induced Ascitic Fluid and Hepatocellular Dysfunction in Severe Acute Pancreatitis

“…Pancreatitis-induced ascitic fluid obtained from the canine model of necrotizing pancreatitis had a lethal effect on rats when administered into their abdominal cavities [7]. It has also been reported that PAF from a canine pancreatitis model caused acute renal failure in healthy dogs, suggesting that the nephrotoxic substances may be present in PAF [8]. We recently demonstrated that PAF contains cytotoxic factors that induce apoptosis in Madin-Darby canine kidney (MDCK) cells [9].…”