Acute pancreatitis in patients with end-stage renal disease without transplantation.

Acute pancreatitis is infrequently described in patients with end-stage renal disease (ESRD) who have not undergone transplantation. We observed 35 attacks of acute pancreatitis in 23 of 1001 patients with ESRD and one additional patient with irreversible acute renal failure, during a ten-year period. Pancreatitis occurred more frequently in association with peritoneal dialysis than with hemodialysis. Four patients died of complications related to a pancreatic pseudocyst, and a fifth died from hemorrhagic pancreatitis. The ten-year incidence of pancreatitis was 2.3% and the overall mortality was 20.8% in patients with ESRD treated without transplantation. We conclude that clinically evident acute pancreatitis occurs more often than has been previously recognized in patients with ESRD who have not undergone transplantation and, particularly, in those patients managed with peritoneal dialysis.