(1408) Clinical Study of the Risk Factors for Severe Acute Pancreatitis Complicated by Acute Kidney Injury

Introduction: To study the clinical characteristics and risk factors for severe acute pancreatitis (SAP) complicated by acute kidney injury (AKI).

Methods: The clinical data of SAP patients admitted to the Department of Critical Care Medicine of Xijing Hospital of Digestive Diseases, Fourth Military Medical University from January 2008 to September 2018 and the onset time was less than 72 hours were retrospectively collected. Patients were divided into AKI group and non-AKI group according to whether AKI occurred. The clinical characteristics, laboratory data, incidence of complications and mortality of the two groups were compared. Univariate analysis and multivariate logistic regression analysis were used to analyze the independent risk factors for AKI in SAP patients.

Results: A total of 402 patients were included in the final analysis, mortality rate at 30 days was 19.2% (77/402). Including 194 (48.3%) in the AKI group and 208 (51.7%) in the non-AKI group，23 patients (11.9%) among the 194 had AKIⅠ, 38 (19.6%) had AKIⅡ, and 133 (68.5%) had AKI Ⅲ. Renal replacement treatment (RRT) was administered in 106 patients (26.4%). The length of ICU stay, incidences of organ failure, and mortality rate in the AKI group were higher than those in the non-AKI group (all P< 0.05). Univariate analysis showed that compared with the non-AKI group, body mass index (BMI), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, serum cystatin C, the proportion of hypocalcemia and hypertriglyceridemia at admission in the AKI group were significantly higher (all P< 0.05). Multivariate logistic regression analysis showed that acute SOFA (OR=2.472, 95% CI: 1.658-4.302, P=0.003), serum cystatin C (OR=2.769, 95% CI: 2.008-4.958, P=0.016), hypocalcemia (OR=6.419, 95% CI 3.776-13.504, P< 0.001) and hypertriglyceridemia (OR=3.178, 95% CI: 1.277-9.852, P=0.027) were independent risk factors for AKI in SAP patients.

Conclusions: Serum cystatin C, hypocalcemia, hypertriglyceridemia, and SOFA scores are independent risk factors for AKI in SAP patients.