Acute kidney injury in patients with acute pancreatitis

Czech version

Authors: N. Petejová ^1,2; Arnošt Martínek ^1,2; V. Teplan ^1–4
Authors‘ workplace: Interní klinika LF OU a FN Ostrava ¹; Katedra interních oborů, LF OU, Ostrava ²; Klinické a výzkumné centrum pro střevní záněty ISCARE I. V. F., a. s., Praha ³; Subkatedra nefrologie, Institut postgraduálního vzdělávání ve zdravotnictví, Praha ⁴
Published in: Gastroent Hepatol 2018; 72(2): 134-142
Category: Chapters from internal medicine: Review Article
doi: https://doi.org/10.14735/amgh2018134

Akutní poškození ledvin je poměrně častým a závažným stavem v klinické medicíně, který může komplikovat primární chorobu pacienta v téměř všech medicínských oborech, hlavně však u kriticky nemocných pacientů hospitalizovaných na jednotce intenzivní péče.

Overview

Introduction:
Acute kidney injury is a common diagnosis in clinical practice, occurring in virtually all fields of medicine. Critically ill patients in intensive care units are especially prone to the development of acute kidney injury.

Backgrounds:
The pathophysiology of acute kidney injury in patients suffering from acute pancreatitis is a result of many simultaneous factors and mechanisms: release of pancreatic amylase from the injured pancreas with resulting impairment of renal microcirculation, hypoxemia, decrease in renal perfusion pressure due to abdominal compartment syndrome, intraabdominal hypertension and hypovolemia. Systemic inflammation also plays an important role in the pathophysiology of acute pancreatitis and acute kidney injury.

Aims:
Early diagnostic evaluation of pancreatitis severity, diagnosis of acute kidney injury and adequate preventive/therapeutic measures can help prevent disease progression to multiple organ dysfunction syndrome. The management of acute kidney injury in patients with acute pancreatitis should take into account the underlying disease as well as the need to support the renal function with or without use of renal replacement therapy or blood purification techniques.

Conclusion:
Early and adequate preventive and therapeutic measures can prolong patient survival, improve outcome and lead to the recovery of kidney function.

Key words:
pancreatitis – acute kidney injury – renal replacement therapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
13. 3. 2018

Accepted:
9. 4. 2018

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