The kallikrein-kinin system in operated and non-operated patients with acute pancreatitis.

The activation of the kallikrein-kinin system is probably one of the pathophysiological factors in acute pancreatitis. The activity of this system was studied in seven patients with fulminant acute pancreatitis treated in the intensive care unit. In four patients the subtotal resection of pancreas was performed. On admission, the activity of plasma prekallikrein, a procompound for the enzyme kallikrein, was low, and urine kallikrein activity was high. The level of plasma kininogen, a substrate for kinin formation, was low. All these findings point out to an activation of the kallikrein-kinin system in acute pancreatitis. During the recovery from the disease, the changes in the activity of kallikrein-kinin system were restored in all the five survivors but not in the two non-survivors. The subtotal resection of pancreas had no consistent effect on the kallikrein-kinin system.