Clinical Characteristics And Prognosis Of Severe Acute Pancreatitis Complicated With Acute Kidney Injury

Objective:To analyze the clinical characteristics and prognosis of severe acute pancreatitis（SAP）complicated with acute renal injury（AKI）,and explore the risk factors affecting renal function and prognosis.Methods:291 patients diagnosed with severe acute pancreatitis in the second affiliated Hospital of Chongqing Medical University from 2014 to2019 were divided into AKI group and non-AKI group according to the KDIGO-AKI criteria.The clinical characteristics and and the prognosis of AKI group were compared,and Logistic regression analysis was used to analyze the risk factors affecting renal function and prognosis.Results:（1）In our study,the mortality rate of SAP patients is12.7%,and SAP-induced AKI patients experienced a significantly higher mortality than those without AKI（P<0.05）.（2）The most common cause of SAP is hyperlipidemia,followed by cholelithiasis.（3）There were significant differences in age,blood pressure,treatment scheme,prognosis,hemoglobin（Hb）,platelet（PLT）,hematocrit（Hct）,Ca²⁺,C-reactive protein（CRP）,procalcitonin（PCT）,serum creatinine（Scr）,blood urea nitrogen（BUN）,serum uric acid（UA）,aspartate aminotransferase（AST）,γ-glutamyltransferase（γ-GT）,serum albumin,coagulation function,Serum amylase,artery blood pH,MCTSI scores and Marshall scores between two groups（P<0.05）.Multivariate Logistic regression analysis showed that PCT,CRP,UA,γ-GT and APTT were influencing factors of SAP complicated with AKI,while systolic blood pressure was a protective factor.（4）Compared with the survival group,the death group had lower diastolic blood pressure,shorter average hospital stay and higher proportion of CRRT.In addition,the death group had higher Scr,BUN,alanine aminotransferase（ALT）,AST,APTT and Marshall scores,while lower PTA,PLT and oxygenation（all P<0.05）.Multivariate Logistic regression analysis showed that the morality-related independent factors were APTT and Marshall scores.Conclusion:Our study suggests that hyperlipidemia is the most common cause of SAP,and the mortality will increase if it is complicated with AKI.Influencing factors of SAP complicated with AKI are PCT,CRP,UA,γ-GT and APTT,while systolic blood pressure was a protective factor.The independent risk factors related to death of SAP-induced AKI patients are APTT and Marshall scores.