Total serum amylase but not lipase correlates with measured glomerular filtration rate

Elevated serum amylase and lipase levels have been reported in patients with renal failure. Because the diagnosis of pancreatitis is often based on elevations in serum amylase or lipase along with abdominal pain, we determined the relationship between total serum amylase, lipase, and glomerular filtration rate (GFR). Thirty-three subjects, 13 men and 20 women (age range, 21-79), were included in the study. There was a statistically significant correlation between serum amylase and the actual GFR (r = -0.43, p = 0.01). However, no such correlation was seen with lipase. No correlation between total serum amylase and lipase was observed. Three subjects had elevated amylase (240-433 U/L, normal 50-225). Three patients had slightly elevated lipase (29-31 U/dl, normal 8-28). All patients were asymptomatic. Of 11 subjects with GFR < 50 cc/min, only one had an elevated amylase and another an elevated lipase. Our data suggest that although the total serum amylase level is determined in part by the GFR, elevations in either amylase or lipase may not occur even in the presence of renal failure. Therefore, even small elevations in the total serum amylase or lipase in a patient with renal insufficiency may be clinically significant.