Acute kidney injury in patients with acute pancreatitis

Abstract

Summary Introduction: Acute kidney injury is a common diagnosis in clinical practice, occurring in virtually all fields of medicine. Critically ill patients on intensive care units are especially prone to the development of acute kidney injury. Methods: Early diagnostic approach of pancreatitis severity, diagnosis of acute kidney injury and adequate preventive/therapeutic measures might help in prevention of disease progression to multiple organ dysfunction syndrome. Results: The pathophysiology of acute kidney injury in patients suffered from acute pancreatitis is a result of many including 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 play an important role in the pathophysiology of acute pancreatitis and acute kidney injury. Discussion: In therapeutic approach of acute kidney injury in patient with acute pancreatitis is necessary to take into account both pathological situations with support of 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 recovery of kidney function.