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LITERATURE COLLECTION
Abstract
Serum was obtained from 55 patients, including 43 with stable chronic renal failure (CRF)
(28 receiving chronic hemodialysis [CHD] and 15 receiving chronic ambulatory peritoneal dialysis
[CAPD]), nine with peritonitis receiving CAPD, and three with pancreatitis receiving CAPD. Total
serum amylase activity, lipase activity, isoamylase fractionation, and lipase concentration were
used to measure pancreatic enzymes. Amylase activity was increased in 35 of 43 patients with
CRF but was greater than threefold elevated in only three. Pancreatic isoamylase activity was
greater than 80% in only one patient with CRF but was greater than 80% in all three patients with
pancreatitis receiving CAPD. Lipase activity was increased in 26 patients and lipase concentration
was elevated in 27. Peritoneal fluid from three patients with pancreatitis receiving CAPD
contained high levels of amylase. Serum amylase and lipase are frequently elevated in patients
with CRF in the absence of clinical pancreatitis. However, serum amylase activity greater than
threefold elevated or the presence of pancreatic enzymes in the peritoneal fluid may suggest
coexistent pancreatitis.
1
Author Royse VL,Jensen DM, Corwin HL.,
Title Pancreatic enzymes in chronic renal failure.Journal/Edition/Page No. Arch Intern Med.1987 Mar;147(3):537-9.
http://www.ncbi.nlm.nih.gov/pubmed?term=%22Royse%20VL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Royse%20VL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Jensen%20DM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Jensen%20DM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Corwin%20HL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed?term=%22Jensen%20DM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Corwin%20HL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed?term=%22Royse%20VL%22%5BAuthor%5D -
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2
Author Anderstam B, Garca-Lpez E, Heimbrger O, Lindholm B
Title Determination of alpha-amylase activity in serum and dialysate from
patients using icodextrin-based peritoneal dialysis fluid.
Journal/Edition/Page No. Perit Dial Int. 2003;23(2):146.
Abstract
OBJECTIVE: Low serum activity of alpha-amylase has been reported in peritoneal dialysis (PD)
patients following treatment with icodextrin-based peritoneal dialysis fluid (IPDF). However, these
results have been questioned because icodextrin interferes with the polysaccharide reagent
included in the assay as a substrate for alpha-amylase in the sample.
DESIGN: We adapted a routine method using p-nitrophenol maltoheptaoside as substrate for the
analysis of total alpha-amylase in serum and dialysate from 27 patients using IPDF. Serum from 12
healthy volunteers and serum and dialysate from 19 PD patients using glucose-based peritoneal
dialysis fluid (GPDF) were used as controls. For the PD patients, time on dialysis ranged from 1 to
24 months (mean 5.7 months) and time of exposure to IPDF ranged from 1 to 52 weeks.
RESULTS: To test for interference and recovery, and thus to validate the alpha-amylase assay,
samples were spiked with IPDF and synthetic alpha-amylase. This revealed that addition of up to
75% IPDF did notinterfere with the assay. Furthermore, alpha-amylase was fully recovered when
spiked in serum from patients treated with IPDF. We show that total alpha-amylase activity is
considerably lower in the serum of IPDF patients (20.3 +/- 16.5 U/L, p
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Journal/Edition/Page No. Semin Dial. 2006;19(5):373.
Abstract
Several laboratory parameters can be altered in advanced renal failure. Results may be
difficult to interpret and may become misleading and unreliable in such a context. On the other
hand, some of the alterations may reflect real abnormalities. Thus sufficient knowledge and careful
judgment are required by the clinician. We reviewed different publications related to biochemical
anomalies in renal failure and report some of the main findings. The sections are divided as
follows: cardiovascular risk factors and markers, inflammation markers, pancreatic and liver
function tests, hormones, bone turnover indices and parathyroid hormone assays, tumor markers,
carbohydrate metabolism indicators, and others. The information provided should be useful to
clinicians involved in the care of renal failure patients.
4Author
Lin XZ, Chen TW, Wang SS, Shiesh SC, Tsai YT, Huang TP, Lee SD,
Ting SW
TitlePancreatic enzymes in uremic patients with or without dialysis.
Journal/Edition/Page No. Clin Biochem. 1988;21(3):189.
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Abstract
One hundred thirty blood samples from 87 patients with renal failure, but without
abdominal pain, were analyzed for blood urea nitrogen (BUN), creatinine, amylase, p-isoamylase,
and lipase simultaneously. We found that 74, 78, and 80% of the patients had hyperamylasemia,
hyperisoamylasemia, and hyperlipasemia. None had amylase higher than five times the upper limit.
A few patients (2.3%) had lipase elevated to more than 10 times the upper limit. No significant
change of pancreatic enzyme level was noted as a result of hemodialysis, but a significant amount
of amylase was removed from the circulation in patients receiving intermittent peritoneal dialysis.
Significantly lower pancreatic enzyme levels were observed in patients with less impairment of
renal function. We conclude that elevation of pancreatic enzymes in uremic patients is more
frequent and more extensive than most articles indicate, and that the extent of increase is related
more to renal function than to the modalities of dialysis the patients received.
5 Author Collen MJ, Ansher AF, Chapman AB, Mackow RC, Lewis JH
Title Serum amylase in patients with renal insufficiency and renalfailure.
Journal/Edition/Page No. Am J Gastroenterol. 1990;85(10):1377.
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Abstract
Results vary with regard to the upper limits of serum amylase seen in patients with renal
failure, and very little has been reported with patients with renal insufficiency not yet requiring
dialysis. To determine the level of serum amylase elevation in renal insufficiency and renal failure,
we determined serum amylase values in 128 subjects with creatinine clearances less than 90
ml/min. Serum amylase remained in the normal range when creatinine clearance was greater than
50 ml/min, and did not become elevated until creatinine clearance was less than 50 ml/min. The
highest serum amylase recorded in the absence of acute pancreatitis was 503 IU/L (normal, less
than 128 IU/L). Serum lipase and trypsin values paralleled those for serum amylase; values
remained normal when creatinine clearance was greater than 50 ml/min, and were normal or
elevated when creatinine clearance was less than 50 ml/min. These results indicate that elevations
of serum amylase (i.e., amylase greater than 128 but less than 500 IU/L) in asymptomatic patients
with impaired renal function are not evident until creatinine clearances fall below 50 ml/min, and
probably do not represent acute pancreatitis.
6 Author Giuseppe Montalto, Antonio Carroccio, VitoSparacino, Domenico Lorello, Daniela Di Martino,Maurizio Soresi, Antonio Galione and Alberto
Notarbartolo
Title Pancreatic enzymes in chronic renal failure andtransplant patients
http://www.springerlink.com/content/?Author=Giuseppe+Montaltohttp://www.springerlink.com/content/?Author=Antonio+Carrocciohttp://www.springerlink.com/content/?Author=Vito+Sparacinohttp://www.springerlink.com/content/?Author=Vito+Sparacinohttp://www.springerlink.com/content/?Author=Domenico+Lorellohttp://www.springerlink.com/content/?Author=Daniela+Di+Martinohttp://www.springerlink.com/content/?Author=Maurizio+Soresihttp://www.springerlink.com/content/?Author=Antonio+Galionehttp://www.springerlink.com/content/?Author=Alberto+Notarbartolohttp://www.springerlink.com/content/?Author=Alberto+Notarbartolohttp://www.springerlink.com/content/?Author=Giuseppe+Montaltohttp://www.springerlink.com/content/?Author=Antonio+Carrocciohttp://www.springerlink.com/content/?Author=Vito+Sparacinohttp://www.springerlink.com/content/?Author=Vito+Sparacinohttp://www.springerlink.com/content/?Author=Domenico+Lorellohttp://www.springerlink.com/content/?Author=Daniela+Di+Martinohttp://www.springerlink.com/content/?Author=Maurizio+Soresihttp://www.springerlink.com/content/?Author=Antonio+Galionehttp://www.springerlink.com/content/?Author=Alberto+Notarbartolohttp://www.springerlink.com/content/?Author=Alberto+Notarbartolo -
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Journal/Edition/Page No. International Journal of Gastrointestinal Cancer Volume12, Number 3, 211-217, DOI: 10.1007/BF02924359
Abstract
The aim of the present study was to determine the frequency and degree of elevated serum levels
of Total Amylase (TA), Pancreatic Amylase (PA), and Lipase (L) activity in patients with chronic
renal failure (CRF) on conservative therapy; CRP on periodical hemodialysis (HD); in renal
transplant (RT) and in a control Group (C). Mean values were significantly higher in all groups
than Group C for TA (p < 0.005), PA (p < 0.0001) and L (p < 0.0001). A statistically significant
correlation was found between TA and L vs creatininemia values in CRF patients, but only up to a
certain level (creatininemia
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Abstract
Objective : To estimate the frequency and severity of acute pancreatitis (AP) associated with
chronic renal failure (CRF) and to find out whether CRF causes AP. Methods : We studied 532
patients with a first episode of AP during the period of 1982-1994. Twenty-one patients had CRF
(endogenous creatinine clearance 3
Ranson's criteria was 47.6% in the CRF group versus 21% in the non-CRF group (p < 0.005) and
by simplified prognostic criteria it was 38 versus 10.3% (p < 0.005), respectively. Overall, CRF
patients had more complications compared with non-CRF (66.6 vs. 26.8%, p < 0.005). CRF
patients with severe AP had high mortality when stratified by either Ranson's >3 (70 vs. 11.1% p 2 (87.5 vs. 20.8%, p < 0.0001). Conclusions : AP in CRF
is frequently of unknown cause, suggesting the role of either CRF or other factors. Irrespective of
cause, AP in CRF is a serious disease, associated with a high morbidity and mortality.
8Author
Morrell Michael Avram
TitleHigh Prevalence of Pancreatic Disease in Chronic
Renal Failure
Journal/Edition/Page No. Nephron 1977;18:68-71 (DOI: 10.1159/000180768)
Abstract
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The prevalence of pancreatic disease was determined in 21 autopsied uremic patients who had died during
the course of maintenance hemodialysis, as compared with 60 autopsied patients without kidney or
pancreatic disease. Histologic criteria of pancreatic disease included. (1) duct ectasia; (2) periductal
fibrosis; (3) ductular proliferation; (4) acinar ductalar metaplasia, and (5) interstitial inflammation or
fibrosis. Significant pancreatic disease was present in 56% of the uremic patients and only 11.8% of the
controls (p < 0.01). Two uremic patients had abscesses in the tail of the pancreas. The clinical
significance of the high prevalence of pancreatic pathologic alterations in uremia remains to be assessed.
9
Author E. B. Pedersen,A. Brock and H. J. Kornerup
Title
Serum Amylase Activity and Renal Amylase ActivityClearance in Patients with Severely Impaired Renal
Function and in Patients Treated with Renal
Allotransplantation
Journal/Edition/Page No.Scandinavian Journal of Clinical & Laboratory
Investigation,1976, Vol. 36, No. 2 , Pages 137-140
http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Pedersen%2C+E.+B.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Brock%2C+A.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Kornerup%2C+H.+J.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Pedersen%2C+E.+B.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Brock%2C+A.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Kornerup%2C+H.+J.) -
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Abstarct
Serum amylase activity was measured in 29 nondialysed patients with severe renal failure,
in 24 uraemic patients treated with chronic haemodialysis, and in 29 patients treated with renal
allotransplantation. Simultaneous measurement of renal amylase activity clearance (cam) and
creatinine clearance (Ccr) was performed in 25 patients with severe renal failure and in 19
transplanted patients. Serum amylase activity was elevated in all three groups. Cam was
significantly correlated to Ccr both in the group with severe renal failure and in the transplanted
group. Unlike in the group of transplanted patients, the ratio Cam/Ccr was significantly increased in
patients with severe impaired renal function. It is concluded that the elevation of serum amylase
activity in patients with impaired renal function is primarily due to decreased glomerular filtration
rate. The value of CAm/Ccr for diagnosing acute pancreatitis is doubtful in patients with severe renal
disease.
10
AuthorMichael D. Levitt, M.D.; Mark Rapoport; And Sidney R.
Cooperband, M.D.
TitleThe Renal Clearance of Amylase in Renal
Insufficiency, Acute Pancreatitis, and
Macroamylasemia
Journal/Edition/Page No.Annals of Internal Medicine,November 1, 1969 vol. 71no. 5 919-925
Abstract
http://www.annals.org/search?author1=MICHAEL+D.+LEVITT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=MARK+RAPOPORT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submithttp://www.annals.org/search?author1=MICHAEL+D.+LEVITT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=MARK+RAPOPORT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submit -
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The renal handling of amylase was studied in patients with renal insufficiency, acute
pancreatitis, and macroamylasemia by measuring the rate of amylase clearance (CAm) relative to the
rate of creatinine clearance (CCr). In renal insufficiency CAm was decreased in proportion to CCr. In
acute pancreatitis, the kidney cleared amylase at a markedly increased rate. The ratio of the
amylase clearance rate to the creatinine clearance rate averaged three times normal early in the
course of acute pancreatitis, and this elevation could persist after the serum amylase had returned
to normal. This increased clearance of amylase makes the urinary amylase a more sensitive
indicator of pancreatitis than is the serum measurement. In contrast to pancreatitis, the high serum
amylase levels found in patients with macroamylasemia are associated with an extremely low
CAm/CCr ratio. These studies suggest that the diagnostic value of amylase measurements may be
enhanced if amylase excretion is related to creatinine excretion.
References
1) Royse VL, Jensen DM, Corwin HL, Pancreatic enzymes in chronic renal failure,Arch
Intern Med. 1987 Mar;147(3):537-9.
2) Anderstam B, Garca-Lpez E, Heimbrger O, Lindholm B, Determination of alpha-
amylase activity in serum and dialysate from patients using icodextrin-based
peritoneal dialysis fluid., Perit Dial Int. 2003;23(2):146.
http://www.ncbi.nlm.nih.gov/pubmed?term=%22Royse%20VL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Jensen%20DM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Corwin%20HL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed?term=%22Royse%20VL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Jensen%20DM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed?term=%22Corwin%20HL%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/2435254http://www.ncbi.nlm.nih.gov/pubmed/2435254 -
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3) Robitaille R, Lafrance JP, Leblanc M, Altered laboratory findings associated with end-
stage renal disease., Semin Dial. 2006;19(5):373.
4) Lin XZ, Chen TW, Wang SS, Shiesh SC, Tsai YT, Huang TP, Lee SD, Ting SW,
Pancreatic enzymes in uremic patients with or without dialysis., Clin Biochem.
1988;21(3):189.
5) Collen MJ, Ansher AF, Chapman AB, Mackow RC, Lewis JH, Serum amylase in patients
with renal insufficiency and renal failure., Am J Gastroenterol. 1990;85(10):1377.
6) Giuseppe Montalto, Antonio Carroccio, Pancreatic enzymes in chronic renal failure and
transplant patients,International Journal of Gastrointestinal CancerVolume 12, Number 3,
211-217, DOI: 10.1007/BF02924359
7) Pitchumoni C. S., Arguello P. ,Agarwal N. ,Yoo J. ; Acute pancreatitis in chronic renal
failure, The American journal of gastroenterology, 1996, vol. 91, no12, pp. 2477-2482 (38
ref
8) Morrell Michael Avram, High Prevalence of Pancreatic Disease in Chronic Renal
Failure, Nephron 1977;18:68-71 (DOI: 10.1159/000180768)
9) E. B. Pedersen, A. Brock and H. J. Kornerup, Serum Amylase Activity and Renal
Amylase Activity Clearance in Patients with Severely Impaired Renal Function and in
Patients Treated with Renal Allotransplantation, Scandinavian Journal of Clinical &
Laboratory Investigation,1976, Vol. 36, No. 2 , Pages 137-140.
10)Michael D. Levitt, M.D.; Mark Rapoport; And Sidney R. Cooperband, M.D., The Renal
Clearance of Amylase in Renal Insufficiency, Acute Pancreatitis, and
Macroamylasemia, Annals of Internal Medicine,November 1, 1969 vol. 71 no. 5 919-925
http://www.springerlink.com/content/?Author=Giuseppe+Montaltohttp://www.springerlink.com/content/?Author=Antonio+Carrocciohttp://www.springerlink.com/content/1537-3649/http://www.springerlink.com/content/1537-3649/12/3/http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(PITCHUMONI)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(PITCHUMONI)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(ARGUELLO)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(AGARWAL)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(YOO)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=listeTitreSerie:%20(The%20American%20journal%20of%20gastroenterology)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Pedersen%2C+E.+B.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Brock%2C+A.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Kornerup%2C+H.+J.)http://www.annals.org/search?author1=MICHAEL+D.+LEVITT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=MARK+RAPOPORT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submithttp://www.springerlink.com/content/?Author=Giuseppe+Montaltohttp://www.springerlink.com/content/?Author=Antonio+Carrocciohttp://www.springerlink.com/content/1537-3649/http://www.springerlink.com/content/1537-3649/12/3/http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(PITCHUMONI)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(ARGUELLO)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(AGARWAL)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=auteursNom:%20(YOO)http://www.refdoc.fr/?traduire=en&FormRechercher=submit&FormRechercher_Txt_Recherche_name_attr=listeTitreSerie:%20(The%20American%20journal%20of%20gastroenterology)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Pedersen%2C+E.+B.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Brock%2C+A.)http://informahealthcare.com/action/doSearch?action=runSearch&type=advanced&result=true&prevSearch=%2Bauthorsfield%3A(Kornerup%2C+H.+J.)http://www.annals.org/search?author1=MICHAEL+D.+LEVITT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=MARK+RAPOPORT&sortspec=date&submit=Submithttp://www.annals.org/search?author1=SIDNEY+R.+COOPERBAND&sortspec=date&submit=Submit