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Digestive Diseases and Sciences

, Volume 64, Issue 2, pp 544–552 | Cite as

Aggressive Resuscitation Is Associated with the Development of Acute Kidney Injury in Acute Pancreatitis

  • Bo Ye
  • Wenjian Mao
  • Yuhui Chen
  • Zhihui Tong
  • Gang Li
  • Jing Zhou
  • Lu KeEmail author
  • Weiqin LiEmail author
Original Article
  • 154 Downloads

Abstract

Introduction

The association between early resuscitation volume and clinical outcomes remains controversial in acute pancreatitis. In the present study, we aimed to identify the association between resuscitation volume and the development of acute kidney injury (AKI) and other clinical outcome metrics.

Methods

Patients admitted to our center with moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) from January 2009 to December 2013 were reviewed retrospectively. Patients were stratified into two groups on the basis of the volume of fluid infused during the first 24 h. The primary clinical endpoint was incidence of AKI. Moreover, AKI lasting time, utilization of continuous renal replacement therapy and lasting time, creatinine increase, and other clinical metrics were also compared. The potential risk factors of new-onset AKI were also analyzed.

Results

A total of 179 patients were included, and aggressive fluid resuscitation (≥ 4 l) was associated with increased incidence of AKI compared with nonaggressive group (53.12% vs. 25.64%, p = 0.008), longer AKI lasting time (p = 0.038), and increased creatinine increase (p < 0.001) during hospitalization. Moreover, utilization of continuous renal replacement therapy was more frequent in aggressive group (40.63% vs. 24.36%, p = 0.108), and the lasting time of continuous renal replacement therapy was also longer (p = 0.181), though both not statistically different. Moreover, in multivariate analysis, aggressive resuscitation [OR 4.36 (1.52–13.62); p = 0.001] and chloride exposure [OR 2.53 (1.26–5.21); p = 0.012] in the first 24 h were risk factors of new-onset AKI.

Conclusion

In patients with MSAP and SAP, aggressive fluid resuscitation was associated with increased incidence and longer duration of AKI. Moreover, aggressive resuscitation and chloride exposure in the first 24 h were risk factors of new-onset AKI.

Keywords

Acute pancreatitis Fluid resuscitation Acute kidney injury Continuous renal replacement therapy 

Notes

Author’s contribution

Dr. WL and LK designed the work, Dr. ZT, GL, and JZ collected the data, Dr. BY wrote the paper, and Dr. WM and Dr. YC analyzed the data. All authors have read and approved the final manuscript.

Funding

This study was supported by the National Science Foundation of China (81770641).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SICU, Research Institute of General Surgery, Jinling HospitalNanjing University School of MedicineNanjingChina

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