Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

01 September 1998

Acute renal failure in patients with acute necrotizing pancreatitis and multiple organ failure

M‡aria Tarj‡anyi, Katalin Darvas, Zolt‡an Va‡mos, Piroska Antony-Mo—reŽ, Tibor F. Tihanyi, Lajos E. Flautner

Med Sci Monit 1998; 4(5): CR780-785 :: ID: 501972

Abstract

Background:Acute renal failure (ARF) is not a rare complication of acute necrotizing pancreatitis with multiple organ failure (MOF), nor of the multiple organ dysfunction syndrome (MODS).
Material/Methods: We studied a group of 44 patients with the MOF syndrome induced by acute necrotizing pancreatitis: 30 patients had ARF. Out of these 30 (68%) ARF patients, we evaluated three scoring systems: APACHE II scores were determined during admission and MOF scores were evaluated daily in each case according to Goris. Ranson scores were evaluated in the first 48 hours in 7 patients. Among these patients, 15 required hemodialysis while the others received conservative therapy. Microbiological samples, CRP and other laboratory tests were analysed.
Results: The survival rate of ARF patients (MOF and acute necrotizing pancreatitis) requiring hemodialysis amounted up to 13 %. The origin of MOF and ARF being mostly sepsis and septic shock. MOF survivor points were 6.6 (5-9) while those of non-survivors 9.9 (7-14). All patients had respiratory failure. Ranson survivor scores were 2.6 and those of non-survivors 4.7. As for the APACHE II scores survivors had 14.3 (5-21), and the non-survivors 16.6 (4-31) points. We noted the fact that patients with more than 25 points died. There was no difference between the number of operations: survivors had 3.2 (1-8) while non-survivors 3 (1-8) operations. Surgical interventions amounted mostly to the removal of all necrotic tissue around the pancreas and lavage. There was no difference in the mean number of hemodialysis between the survivors (7) and non-survivors (6.4). Histology performed at autopsy showed either tubular necrosis or glomerular necrosis. Bacteria responsible for septic complications were as follows: Streptococcus, Pseudomonas, Staphylococcus and Candida albicans.
Conclusions:The prognosis of a patient with ARF is poor. We think that an adequate operation performed at the proper time as well as early dialysis treatment are needed to improve the survival rate. APACHE II scores did not predict the development of the MOF syndrome in patients with acute pancreatitis.

Keywords: acute renal failure, Multiple Organ Failure, Multiple Organ Dysfunction Syndrome, acute necrotizing pancreatitis, Surgery, hemodialysis

Add Comment 0 Comments

Editorial

01 June 2024 : Editorial  

Editorial: Concerns as Highly Pathogenic Avian Influenza (HPAI) Virus of the H5N1 Subtype is Identified in Dairy Cows and Other Mammals

Dinah V. Parums

DOI: 10.12659/MSM.945315

Med Sci Monit 2024; 30:e945315

0:00

In Press

Clinical Research  

Trust and Support for Cancer Research Biobanks: Insights from Cancer Patients in Poland

Med Sci Monit In Press; DOI: 10.12659/MSM.944263  

Clinical Research  

Morphological and Dimensional Analysis of the Nasopalatine Canal: Insights from Cone-Beam Computed Tomograp...

Med Sci Monit In Press; DOI: 10.12659/MSM.944424  

Clinical Research  

Hemorrhagic Cysts in the Pancreas: Risk Factors, Treatment, and Outcomes – Insights from a Single-Center Study

Med Sci Monit In Press; DOI: 10.12659/MSM.941955  

Clinical Research  

Perioperative Administration of Tranexamic Acid and Low Molecular Weight Heparin for Enhanced Blood Managem...

Med Sci Monit In Press; DOI: 10.12659/MSM.944063  

Most Viewed Current Articles

14 Dec 2022 : Clinical Research   1,421,178

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990

0:00

17 Jan 2024 : Review article   1,355,487

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

16 May 2023 : Clinical Research   690,090

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

01 Jan 2022 : Editorial   50,113

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750