ACUTE-RENAL-FAILURE IN PATIENTS WITH ACUTE-PANCREATITIS - PREVALENCE,RISK-FACTORS, AND OUTCOME

A total of 267 consecutive patients presenting with acute pancreatitis were studied restrospectively. We analysed the collected data to dete rmine the prevalence of acute renal failure (ARF), and factors signifi cantly predisposing to its occurrence and outcome. The prevalence of A RF in our patients was 16%. Only 2% had isolated ARF. Seventy-three pe rcent of patients with additional organ system failure suffered ARF af ter the onset of other organ failure. The number of organ system failu re was significantly greater before, compared to after, the developmen t of ARF. Using multiple logistic regression we found that pre-existin g chronic disease and cardiovascular and haematological failure were i ndependent risk factors positively related to the development of ARF, whereas systemic infection was not. Overall mortality from ARF was 81% . Chronic disease, local complications and the presence of additional organ system failure and their number significantly increased mortalit y in ARF patients. No patients requiring renal replacement therapy sur vived. ARF is a common complication of severe acute pancreatitis, but occurs late in the disease course, and mostly preceded by other organ system failure. The prognosis of patients with ARF is extremely poor, indicating that more emphasis should be placed on prevention of ARF.