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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(2): 134–142. doi:10.14735/amgh2018134.

Acute kidney injury in patients with acute pancreatitis

Naděžda Petejová1,2, Arnošt Martínek Orcid.org  1,2, Vladimír Teplan Orcid.org  3,4,5

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Summary

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.

Keywords

acute kidney injury, renal replacement therapy, pancreatitis

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