Adapted with permission from Agrawal M, Swartz R. Acute renal failure [published correction appears in Am Fam Physician. The definition of acute kidney injury indicates that a rise in creatinine has occurred within 48 hours, although in the outpatient setting, it may be hard to ascertain when the rise actually happened. A high serum creatinine level in a patient with a previously normal documented level suggests an acute process, whereas a rise over weeks to months represents a subacute or chronic process.
According to multivariate logistic regression analysis, serum CYS-Cwas the independent and significant indicator for AKI in patients with acute pancreatitis Table 3. As shown in Figure 2 and Table 4AKI in patients with acute pancreatitis could be identified with a sensitivity of Indicators for AKI in patient with acute pancreatitis by univariate logistic regression analysis.
Indicators for AKI in patient with acute pancreatitis by multiple logistic regression analysis. Discussion AKI is a clinical syndrome defined as the abrupt within 48 h and sustained decline of renal function caused by a variety of factors including insufficient renal blood perfusion, renal toxic substances, inflammatory factors, and urinary tract obstruction.
At present, there is Acute kidney injury no specific treatment in clinical practice, and the mortality rate remains high. In this study, 18 7. There was a higher percentage of AKI in males This result was consistent with previous reports [ 3 ], suggesting that male patients with acute pancreatitis were more apt to developing AKI.
Studies showed that more than a half of deaths among SAP patients occurred within the first week of acute pancreatitis [ 24 ]. Thus, early interventions of AKI are urgently needed for the patients in this critical stage. Although the pathogenesis of AKI in SAP is not fully elucidated, the effect of pancreatic amylase on the renal microcirculation, hypoxemia, or a toxic effect of excessively produced pancreatic phospholipase A2 on the proximal tubules may lead to AKI.
These factors cause a decrease in renal perfusion and damage to the renal tubules and the increase in small molecule substance concentrations [ 12 ] consequently. Multiple new molecular markers have been found to predict AKI in patients at the early stage. However, the predictors of AKI in patients with acute pancreatitis are unclear.
These results suggested that liver function indexes might not be adopted to predict AKI in patients with acute pancreatitis. These results suggested that AKI in patients with acute pancreatitis have a greater increase because of injury of renal function in these subjects.
Univariate logistic regression analysis demonstrated that these variables might be significant indicators for AKI in patients with acute pancreatitis.
Currently, serum Cr, serum Bun, and urine volume are used to evaluate kidney function. However, these indices are extremely limited for the early diagnosis of kidney injury [ 28 ] and are easily affected by some nonrenal factors [ 29 ].
Serum CYS-C is a cysteine proteinase enzyme inhibitor, and it has low molecular weight and does not bind to proteins. It is freely filtered by glomerulus [ 30 ]. Previous studies showed that serum CYS-C was an independent and significant indicator for predicting AKI secondary to decompensated cirrhosis [ 32 ] and after radical gastrectomy [ 33 ].Acute kidney injury is the sudden and dramatic loss of kidney function.
This can happen rapidly, often in just a few days. In many cases the kidney can recover almost completely from acute kidney failure, but urgent treatment including dialysis may be needed while waiting for the kidneys to recover.
Acute kidney failure happens when your kidneys suddenly stop working. Learn the symptoms, causes, and treatments for this serious medical condition. Merck Manuals: “Acute Kidney Injury.”. Acute kidney injury, or AKI, is “a syndrome that results in a sudden decrease in kidney function or kidney damage within a few hours or few days,” according to the National Kidney Foundation.
After suffering impairment, the kidneys become unable to filter waste products from the blood, leading ultimately to myriad forms of organ failure.
Acute kidney injury (AKI) is the most common cause of organ dysfunction in critically ill adults, with a single episode of AKI, regardless of stage, carrying a significant morbidity and mortality risk. The study is aimed at studying the incidence of acute kidney injury (AKI) and exploring the potential predictor for AKI in patients with acute pancreatitis.
A retrospective study adopting a stratified cohort sampling design was performed in a cohort of patients () diagnosed with acute pancreatitis without any renal injury. Acute kidney injury An abrupt or rapid decline in renal function as evidenced by a rapid rise in serum creatinine or decrease in urine output.
Creatinine clearance or filtration is dependent on the glomerular filtration rate (GFR).