Three cases of acute pancreatitis in long-term hemodialysis

Abstract

Although pancreatic lesions are known to be relatively common in patients with chronic renal failure, there have been few reports of acute pancreatitis in long-term hemodialysis patients in Japan. We observed acute pancreatitis in three of 177 patients in long-term hemodialysis (mean; 5.8 years, range 0.5-17 years) during an eight-year period. The underlying cause of chronic renal failure was chronic lomerulonephritis in all cases. In all patients, the diagnosis of acute pancreatitis was established on clinical grounds (nausea, vomiting, epigastralia, fever), elevated serum amylase level (amylase>700SU, pancreatic isoamylase>80%) and enlarged pancreas on sonography. Two patients required daily intravenous hyperalimentation and short-time hemodialysis (5 and 7 days). All patients received antibiotics and protease inhibitors. Two patients recovered completely and one died from cardiac failure 11 days after the relapse of acute pancreatitis. Possible etiological factors were hypercalcemia (2 cases) and hyerparathyroidism (1 case). The association between pancreatitis and chronic renal failure is discussed.