Frontiers in Medicine (Aug 2021)

Initial Renal Function (eGFR) Is a Prognostic Marker of Severe Acute Pancreatitis: A Cohort-Analysis of 1,224 Prospectively Collected Cases

  • Pál Tod,
  • Pál Tod,
  • Nelli Farkas,
  • Dávid Németh,
  • Gábor Szénási,
  • Áron Vincze,
  • Roland Hágendorn,
  • László Czakó,
  • Dóra Illés,
  • Ferenc Izbéki,
  • Veronika Dunás-Varga,
  • Mária Papp,
  • József Hamvas,
  • Márta Varga,
  • Katalin Gombos,
  • Tamás Nagy,
  • Zsolt Márton,
  • Nándor Faluhelyi,
  • Imola Török,
  • Ali Tüzün Ince,
  • Shamil Galeev,
  • Péter Jenő Hegyi,
  • Andrea Szentesi,
  • Andrea Szentesi,
  • Andrea Párniczky,
  • Andrea Párniczky,
  • Zsolt Szakács,
  • Péter Hegyi,
  • Péter Hegyi,
  • Péter Hegyi,
  • Péter Hegyi,
  • Péter Hamar,
  • Péter Hamar

DOI
https://doi.org/10.3389/fmed.2021.671917
Journal volume & issue
Vol. 8

Abstract

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Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the prognostic relevance of renal function based on estimated glomerular filtration rate (eGFR).Methods: A prospective registry of AP patients was established by the Hungarian Pancreatic Study Group. Data of 1,224 consecutive patients were collected between 2012 and 2017. Patients were divided into 3 groups according to their eGFR measured within 24 h of hospitalization: normal renal function: >90 mL/min, mild to moderate renal functional impairment: 30–90 mL/min and severe renal dysfunction: <30 mL/min. Associations of eGFR with outcome (survival, length of hospitalization, AP severity, blood glucose), inflammatory markers (erythrocyte sedimentation rate, white blood cell count), anemia and organ failure (heart, kidney, liver) were analyzed.Results: Death, longer hospitalization and severe AP, but not the cause of AP, were significantly associated with lower eGFR. The inflammatory markers (CRP, WBC count) but not anemia (Hb, Htk) were closely associated with severe renal dysfunction. Renal function was associated with heart and renal failure but not with other complications of AP such as respiratory failure, local pancreatic complications, diabetes or peptic ulcer. eGFR was not associated with liver damage (ALAT, γ-GT) or liver function (serum bilirubin) although biliary complications, alcohol and metabolic syndrome were the most common etiologies of AP.Conclusions: Our study suggests a useful prognostic value of initial eGFR in AP patients. Even mild eGFR reduction predicted mortality, severity of AP and the length of hospitalization. Thus, precise evaluation of renal function should be considered for assessing AP severity and outcome.

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