Pancreatic-type hyperamylasemia in end-stage renal disease

Pancreatic-type isoamylase (P-type) and salivary-type isoamylase (S-type) activities were determined by the wheat protein inhibitor method in 29 patients with end-stage renal disease and in 38 healthy volunteers. Serum levels of total amylase (322 +/- 43 units/liter) and P-type (212 +/- 39 units/liter) in ESRD were significantly higher than those of controls (total: 142 +/- 7 units/liter, P less than 0.01; P-type: 52 +/- 4 units/liter, P less than 0.01). There was no significant difference between S-type activities in ESRD (110 +/- 16 units/liter) and in controls (90 +/- 6 units/liter). The ratios of amylase clearance to creatinine clearance (Cam/Ccr) and S-type clearance to creatinine clearance (Cs-amy/Ccr) rose significantly in ESRD(Cam/Ccr: 5.7 +/- 0.6%; Cs-amy/Ccr: 4.3 +/- 0.55%) compared to controls (Cam/Ccr: 3.2 +/- 0.24%, P less than 0.01; Cs-amy/Ccr: 2.1 +/- 0.17%, P less than 0.01). The ratio of P-type clearance to creatinine clearance (Cp-amy/Ccr) revealed no significant difference between ESRD (5.5 +/- 0.54%) and controls (5.6 +/- 0.42%). The renal excretion of P-type appeared to be more impaired than that of S-type in ESRD.