Significance of Serum Lipase in Patients Undergoing Hemodialysis

Shibasaki, Toshiaki; Matsuda, H; Ohno, Iwao; Gomi, Hideho; Nakano, Hiroshi; Misawa, T; Abe, Seiichiro; Ishimoto, F; Kisugi, Reiko; Ikeda, Katsusuke; Machida, Koji; Sakai, Osamu

doi:10.1159/000169015

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…Phospholipase A2 appears no more reliable than amylase in advanced renal failure (54). Circulating trypsinogen concentrations are also elevated in chronic renal failure patients (predialysis, on hemodialysis, and on peritoneal dialysis) and to a greater extent than amylase and lipase; it is therefore an unreliable marker in the presence of renal dysfunction (55,56).…”

Section: Pancreatic Markers and Liver Function Testsmentioning

confidence: 99%

Reviews: Altered Laboratory Findings Associated with End‐Stage Renal Disease

Robitaille¹,

Lafrance

Leblanc

2006

Seminars in Dialysis

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Several laboratory parameters can be altered in advanced renal failure. Results may be difficult to interpret and may become misleading and unreliable in such a context. On the other hand, some of the alterations may reflect real abnormalities. Thus sufficient knowledge and careful judgment are required by the clinician. We reviewed different publications related to biochemical anomalies in renal failure and report some of the main findings. The sections are divided as follows: cardiovascular risk factors and markers, inflammation markers, pancreatic and liver function tests, hormones, bone turnover indices and parathyroid hormone assays, tumor markers, carbohydrate metabolism indicators, and others. The information provided should be useful to clinicians involved in the care of renal failure patients.

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Section: Pancreatic Markers and Liver Function Testsmentioning

confidence: 99%

Reviews: Altered Laboratory Findings Associated with End‐Stage Renal Disease

Robitaille¹,

Lafrance

Leblanc

2006

Seminars in Dialysis

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“…The reason could be a modified albumin binding capacity during dialysis due to administered heparin [43]. Thus, heparin provokes the release of lipolytic enzymes [44], leading to hydrolysis of triglycerides and release of free fatty acid and increasing their plasma concentrations. It has been shown that free fatty acids displace drugs and ligands (also for IS, IAA and Trp) from their protein binding sites [45,46] and that Trp increases displacement of IS and IAA [47].…”

Section: Discussionmentioning

confidence: 99%

Serum Levels and Removal by Haemodialysis and Haemodiafiltration of Tryptophan-Derived Uremic Toxins in ESKD Patients

Paats

Adoberg

Arund

et al. 2020

IJMS

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Tryptophan is an essential dietary amino acid that originates uremic toxins that contribute to end-stage kidney disease (ESKD) patient outcomes. We evaluated serum levels and removal during haemodialysis and haemodiafiltration of tryptophan and tryptophan-derived uremic toxins, indoxyl sulfate (IS) and indole acetic acid (IAA), in ESKD patients in different dialysis treatment settings. This prospective multicentre study in four European dialysis centres enrolled 78 patients with ESKD. Blood and spent dialysate samples obtained during dialysis were analysed with high-performance liquid chromatography to assess uremic solutes, their reduction ratio (RR) and total removed solute (TRS). Mean free serum tryptophan and IS concentrations increased, and concentration of IAA decreased over pre-dialysis levels (67%, 49%, −0.8%, respectively) during the first hour of dialysis. While mean serum total urea, IS and IAA concentrations decreased during dialysis (−72%, −39%, −43%, respectively), serum tryptophan levels increased, resulting in negative RR (−8%) towards the end of the dialysis session (p < 0.001), despite remarkable Trp losses in dialysate. RR and TRS values based on serum (total, free) and dialysate solute concentrations were lower for conventional low-flux dialysis (p < 0.001). High-efficiency haemodiafiltration resulted in 80% higher Trp losses than conventional low-flux dialysis, despite similar neutral Trp RR values. In conclusion, serum Trp concentrations and RR behave differently from uremic solutes IS, IAA and urea and Trp RR did not reflect dialysis Trp losses. Conventional low-flux dialysis may not adequately clear Trp-related uremic toxins while high efficiency haemodiafiltration increased Trp losses.

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“…The amylase and lipase in our patient declined with the persistence of lesions. Of note, marked elevations of amylase and lipase, up to three times normal, can be seen in patients with ESRD on dialysis, not necessarily indicating pancreatitis . Vaziri et al measured serum amylase and lipase from 34 patients with ESRD, with no indication of pancreatic pathology .…”

Section: Discussionmentioning

confidence: 99%

Pancreatic panniculitis in active systemic lupus erythematosus

et al. 2019

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This report documents the case of a 64‐year‐old African‐American female with new end‐stage renal disease (ESRD), diagnosed with systemic lupus erythematosus (SLE) on renal biopsy and serologies including a positive ANA (>1:2560), positive anti‐Sm antibodies, low titer anti‐RNP antibodies, high titer anti‐Ro antibodies, anti‐dsDNA antibodies, lupus anticoagulant, and hypocomplementemia. She was also noted to have tender nodules on the bilateral shins. Excisional biopsy of one of the nodules showed marked fat necrosis with “ghost cells” and patchy basophilic granular debris consistent with pancreatic panniculitis. Further examination for pancreatic pathology showed an elevated lipase of 585 U/L (reference range 8‐78 U/L) and amylase of 214 U/L (reference range 25‐125 U/L). However, computed tomography imaging showed no evidence of pancreatitis or pancreatic tumors. This is very similar to another case recently reported in the literature. Similarities of these two cases (African‐American females with lupus nephritis on dialysis) may represent a particular subset of SLE patients at increased risk for pancreatic panniculitis.

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Significance of Serum Lipase in Patients Undergoing Hemodialysis

Cited by 10 publications

References 7 publications

Reviews: Altered Laboratory Findings Associated with End‐Stage Renal Disease

Reviews: Altered Laboratory Findings Associated with End‐Stage Renal Disease

Serum Levels and Removal by Haemodialysis and Haemodiafiltration of Tryptophan-Derived Uremic Toxins in ESKD Patients

Pancreatic panniculitis in active systemic lupus erythematosus

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