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Pathophysiology of acute kidney injury in severe acute pancreatitis-an overview

Gastroenterology & Hepatology: Open Access
Piyush Mathur,1 Sandeep Vaishnav2


Acute pancreatitis (AP) is a common disorder of the pancreas and its severity ranges from mild self-limited disease to severe acute pancreatitis (SAP). Acute kidney injury (AKI) is a frequent complication of severe acute pancreatitis and carries a very poor prognosis, particularly if renal replacement therapy (RRT) is required, with mortality rates between 25% and 75%. Different key pathophysiologic processes include release of pancreatic enzymes with resulting impairment of renal microcirculation, hypoxemia, hypovolemia, intra abdominal hypertension, endotoxin and cytokines mediated injury. 


AP, acute pancreatitis, SAP, severe acute pancreatitis, AKI, acute kidney injury, PAF, platelet activating factor, SIRS, systemic inflammatory reaction syndrome, NO, nitric oxide, AA, arachodonic acid, ACS, abdominal compartment syndrome, IAP, intra-abdominal pressure, RBC, red blood cell, acute pancreatitis, acute kidney injury, renal replacement therapy, intra abdominal hypertension, endotoxin