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Pancreatitis and renal disease
Scandinavian Journal of Gastroenterology
|January 1, 1977
Summary
Pancreatitis is a serious risk for renal transplant patients, especially those on prednisone and azathioprine. Chronic renal failure patients may also develop pancreatitis, potentially linked to hyperparathyroidism.
Area of Science:
- Nephrology
- Gastroenterology
- Immunology
Background:
- Pancreatitis has been documented post-renal transplantation but not previously linked to chronic renal failure.
- Immunosuppressive therapy, particularly prednisone and azathioprine, is a potential risk factor in transplant patients.
- Hyperparathyroidism is a known complication of chronic renal failure and may play a role in pancreatitis development.
Purpose of the Study:
- To investigate the occurrence and potential causes of pancreatitis in patients with chronic renal failure and those undergoing renal transplantation.
- To compare the clinical presentation and outcomes of pancreatitis in transplanted versus non-transplanted renal failure patients.
Main Methods:
- Retrospective analysis of 168 renal transplant patients, identifying five cases of pancreatitis.
- Clinical evaluation and serum amylase level assessment (>900 iu/l) for pancreatitis diagnosis.
- Comparison with four non-transplanted patients with chronic renal failure and a control group with chronic renal failure.
Main Results:
- Five of 168 renal transplant patients developed pancreatitis, with three fatalities, all on prednisone and azathioprine.
- Four non-transplanted patients with chronic renal failure experienced pancreatitis without immunosuppressants; two were on frusemide.
- Elevated serum amylase levels were specific to pancreatitis patients, not found in controls. Hyperlipidaemia and hypercalcaemia were absent in all pancreatitis cases.
- Elevated serum parathormone levels, common in uremia, suggest a potential link to pancreatitis in renal failure.
Conclusions:
- Pancreatitis poses a significant mortality risk in renal transplant recipients, particularly those on immunosuppressive therapy.
- Chronic renal failure patients may develop pancreatitis, with hyperparathyroidism being a potential contributing factor.
- Prompt diagnosis and management are crucial for improving outcomes in pancreatitis associated with renal disease and transplantation.