Renal function in experimentally induced acute pancreatitis in dogs: How it is affected by the nephrotoxic substance in pancreatic exudate from ascitic fluid
Renal failure occurring in dogs during experimental acute pancreatitis and the effect on renal function of intravenous injections of ascitic fluid which accumulated during the acute pancreatitis were studied. Five hours after the induction of acute pancreatitis, the accumulation of 200 to 400 ml of ascitic fluid, and an elevation in hematocrit as well as a decreased mean arterial pressure were observed, which suggested hypovolemia due to plasma loss. At the same time, the renal blood flow, glomerular filtration rate, and urinary output decreased significantly. Hypovolemia was observed to be the main cause of renal failure in accordance with previous reports. When the sterile ascitic fluid was injected into healthy dogs, temporary hypotension was observed without changes in the hematocrit. However, the renal blood flow, glomerular filtration rate and urinary output decreased, together with an elevation in renal vascular resistance, even after the hypotension had returned to normal. This study shows that renal failure associated with acute pancreatitis occurred mainly as a direct result of hypovolemia but also that the sterile ascitic fluid contained nephrotoxic substances which were suspected to be unrelated to vasoactive substances or protease. Their removal is therefore necessary for the treatment and prevention of renal failure complicating acute pancreatitis.
Key Wordsrenal failure acute pancreatitis ascitic fluid nephrotoxic substance
Unable to display preview. Download preview PDF.
- 1.Lucas CE, Ledgerwood AM. Shock and renal failure. In: Bradley EZ III, ed. Complication of pancreatitis: Medical and surgical management. Philadelphia: WB Saunders 1982; 33–50.Google Scholar
- 3.Balslor JT, Jargensen HE, Nielsen R. Acute renal failure complicating severe pancreatitis. Acta Chir Scand 1962; 124: 348–354.Google Scholar
- 4.Beisel WR, Herndon EG Jr, Meyess JE Jr, Stones CZ. Acute renal failure as a complication of acute pancreatitis. Arch Intern Med 1959; 104: 534–543.Google Scholar
- 18.Satake K, Koh I, Nishiwaki H, Umeyama K. The management of acute pancreatitis: Toxicity of ascitic fluid from experimental pancreatitis in dogs. In: Sato T, Yamauchi H, eds Pancreatitis: Its pathophysiology and clinical aspect. Tokyo: Univ. Tokyo Press 1985; 239–251.Google Scholar