Raghavendra Prasada1, Gaurav Muktesh1, Jayanta Samanta1, Phulen Sarma2, Sukhvinder Singh3, Sunil K Arora3, Narendra Dhaka1, Raja Ramachandran4, Vikas Gupta5, Saroj Kant Sinha1, Rakesh Kochhar6. 1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Immunology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 4. Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 5. Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 6. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: dr_kochhar@hotmail.com.
Abstract
OBJECTIVES: To study the natural course of patients with acute pancreatitis (AP) with acute kidney injury (AKI) and their cytokine profile. METHODS: Natural course of patients with AP and AKI was studied in 97 individuals. Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured at presentation and at 72 h in patients who developed AKI. RESULTS: Amongst the entire cohort, 16.4% patients developed AKI (persistent AKI - 11 patients, transient AKI - 5 patients). Mortality rate was 25% amongst patients with AKI. Levels of IL-6 (p = 0.035) and IL-8 (p = 0.002) were found to be significantly higher in the AKI group. On multivariate analysis, IL-8 levels at baseline were found to be an independent predictor of AKI. AKI group had significant rise of TNF-α (P < 0.001), IL-6 (P < 0.001) and IL- 1β (P < 0.001) on day 3 whereas persistent-AKI group had significant rise of TNF-α (p = 0.031), IL-6 (p = 0.001) and IL-1β on day 3 and significant decline of IL-10 (p = 0.015). Using a cut-off of 105 pg/ml, IL-8 levels at baseline could predict AKI with a sensitivity of 87.5% and specificity of 59.2%, with area under the curve being 0.744 (p = 0.002). CONCLUSION: AP patients developing AKI have poor prognosis. IL-8 levels can predict AKI in patients with AP.
OBJECTIVES: To study the natural course of patients with acute pancreatitis (AP) with acute kidney injury (AKI) and their cytokine profile. METHODS: Natural course of patients with AP and AKI was studied in 97 individuals. Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured at presentation and at 72 h in patients who developed AKI. RESULTS: Amongst the entire cohort, 16.4% patients developed AKI (persistent AKI - 11 patients, transient AKI - 5 patients). Mortality rate was 25% amongst patients with AKI. Levels of IL-6 (p = 0.035) and IL-8 (p = 0.002) were found to be significantly higher in the AKI group. On multivariate analysis, IL-8 levels at baseline were found to be an independent predictor of AKI. AKI group had significant rise of TNF-α (P < 0.001), IL-6 (P < 0.001) and IL- 1β (P < 0.001) on day 3 whereas persistent-AKI group had significant rise of TNF-α (p = 0.031), IL-6 (p = 0.001) and IL-1β on day 3 and significant decline of IL-10 (p = 0.015). Using a cut-off of 105 pg/ml, IL-8 levels at baseline could predict AKI with a sensitivity of 87.5% and specificity of 59.2%, with area under the curve being 0.744 (p = 0.002). CONCLUSION: AP patients developing AKI have poor prognosis. IL-8 levels can predict AKI in patients with AP.
Authors: Balamurugan Packialakshmi; Ian J Stewart; David M Burmeister; Kevin K Chung; Xiaoming Zhou Journal: Ren Fail Date: 2020-11 Impact factor: 2.606