2026-05-30T11:39:32Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/411362026-02-03T11:17:24Zcom_10630_2254col_10630_37953

00925njm 22002777a 4500 dc Herrera-Gutiérrez, Manuel Enrique author Seller Pérez, Gemma Luisa author De La Rubia De Gracia, Carlos author Chaparro Sánchez, María José author Nacle López, Belén author 2000-11-09 Background: Acute renal failure (ARF) complicating severe acute pancreatitis (SAP) carries a high mortality. Clinically useful scores to define patients who will develop this complication are lacking. We try to determine the incidence of ARF and variables predicting the appearance and severity of the episodes. Material and method: Retrospective study of all SAP patients admitted in an intensive care unit between 1991 and 1998 (n = 154). Results: ARF incidence was 42%. Haemodynamic instability, APACHE II and Ranson score were related to ARF development. 62.2% of severe ARF patients had multiple organ failure (MOF). Mortality was 71.2% compared to 6.8% in patients without ARF (39.9% in mild ARF and 94.6% in severe ARF). Etiology relates to mortality (prerenal [46.4%], after severe hypotensive episode [71.4%], in MOF [93.3%]; p < 0.005). 63.6% patients required replacement therapy (hemofiltration [HF] 95.5%), with a mortality of 89.3% (100% for intermittent dialysis compared to 88% with HF). In 32% patients treated with HF, ARF improved (when initiated early mortality was 76.9% compared to a 100% when initiated in more advanced stages) (p < 0.001). Logistic regression analysis showed that ARF severity and haemodynamic failure were related with mortality. Conclusion: ARF is a frequent and early complication of SAP, worsening its prognosis. FRA severity is related to the outcome. Need of replacement therapy supposes a high mortality. In this setting, HF seems to have advantages over conventional dialysis. Herrera Gutiérrez ME, Seller Pérez G, de La Rubia De Gracia C, Chaparro Sánchez MJ, Nacle López B. Características y valor pronóstico del fracaso renal agudo en la pancreatitis aguda grave [Acute renal failure profile and prognostic value in severe acute pancreatitis]. Med Clin (Barc). 2000 Dec 2;115(19):721-5. Spanish. doi: 10.1016/s0025-7753(00)71674-5. PMID: 11141437. https://hdl.handle.net/10630/41136 10.1016/s0025-7753(00)71674-5 Riñones - Enfermedades Páncreas - Enfermedades Epidemiología Enfermedades - Complicaciones y secuelas Enfermedades - Etiología Características y valor pronóstico del fracaso renal agudo en la pancreatitis aguda grave.