Renal vasoconstriction in association with acute pancreatitis

Abstract

Renal failure is a common complication of pancreatitis. To better understand this association, renal function was evaluated in eleven patients in the acute phase of alcoholic pancreatitis and again during convalescence in seven patients. Parameters measured included glomerular filtration rate, effective renal plasma flow, true renal plasma flow, renal vascular resistance, osmolar clearance, amylase clearance, renal oxygen consumption, cardiac output, and peripheral resistance. Average glomerular filtration rate, effective renal plasma flow, and true renal plasma flow were decreased in the acute phase. Osmolar clearance, amylase clearance, mean arterial blood pressure, renal vascular resistance, and total peripheral resistance rose in the acute phase. Cardiac index and extracellular fluid space remained normal. All parameters returned toward normal with convalescence. The combination of systemic hypertension, increased total peripheral resistance and renal vascular resistance, and normal extracellular fluid space suggests a release of a vasopressor during the acute phase of pancreatitis. The therapeutic implications of these findings including the role of vasodilator infusion are discussed.