Bruno M J, van Westerloo D J, van Dorp W T, Dekker W, Ferwerda J, Tytgat G N, Schut N H
Academic Medical Centre, Division of Gastroenterology and Hepatology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Gut. 2000 Mar;46(3):385-9. doi: 10.1136/gut.46.3.385.
It has been suggested that the incidence of acute pancreatitis in patients with end stage renal failure is increased.
To assess the risk of acute pancreatitis in patients on long term peritoneal dialysis and long term haemodialysis compared with the general population, to evaluate its clinical course and outcome, and to identify possible aetiological factors.
All patients who were maintained on long term peritoneal dialysis and/or haemodialysis (total dialysis time more than six weeks) from January 1989 to March 1998 in a large general hospital in The Netherlands.
Retrospective cohort study. Standardised ratios (as an approximate relative risk) between the incidence of acute pancreatitis in haemodialysis or peritoneal dialysis and the general population were calculated. Possible risk factors were identified. Patients with and without acute pancreatitis were compared.
In 269 patients on haemodialysis (total of 614 person years), one patient developed an attack of acute pancreatitis. Patients on haemodialysis did not show an increased risk for acute pancreatitis compared with the general population (standardised ratio 11; 95% confidence interval (CI) 0.275 to 60.5). In 128 patients on peritoneal dialysis (total of 241 person years), seven patients had nine attacks of acute pancreatitis. Patients on peritoneal dialysis had a significantly and highly increased risk for acute pancreatitis (standardised ratio 249; 95% CI 114 to 473). Mortality in this series of nine attacks was 11%. No single aetiological risk factor could be identified.
The risk of acute pancreatitis in patients on long term peritoneal dialysis is significantly and highly increased compared with the general population. The underlying causal mechanisms remain to be elucidated.
有人提出终末期肾衰竭患者急性胰腺炎的发病率有所增加。
评估长期腹膜透析和长期血液透析患者与普通人群相比发生急性胰腺炎的风险，评估其临床病程及转归，并确定可能的病因学因素。
1989年1月至1998年3月在荷兰一家大型综合医院接受长期腹膜透析和/或血液透析（总透析时间超过六周）的所有患者。
回顾性队列研究。计算血液透析或腹膜透析患者急性胰腺炎发病率与普通人群之间的标准化比率（作为近似相对风险）。确定可能的风险因素。对发生和未发生急性胰腺炎的患者进行比较。
在269例血液透析患者中（总计614人年），1例发生急性胰腺炎发作。与普通人群相比，血液透析患者发生急性胰腺炎的风险未增加（标准化比率1.1；95%置信区间（CI）0.275至6.05）。在128例腹膜透析患者中（总计241人年），7例患者发生9次急性胰腺炎发作。腹膜透析患者发生急性胰腺炎的风险显著且高度增加（标准化比率24.9；95%CI 11.4至47.3）。这9次发作的死亡率为11%。未发现单一的病因学风险因素。
与普通人群相比，长期腹膜透析患者发生急性胰腺炎的风险显著且高度增加。潜在的因果机制仍有待阐明。
