Abstract

PINO SIFONTES, H et al. Elevación de creatinina sérica como indicador de necrosis pancreática. Gen [online]. 2011, vol.65, n.2, pp.92-95. ISSN 0016-3503.

Acute Pancreatitis (AP) is a self-limited pathology in 80% of the cases; these cases generally evolve towards total recovery. Its evolution can be mild or severe. The severe form varies from a 10% to a 25%, and is associated with organ failure and/or local complications as pancreatic necrosis. In Venezuela severe AP is an important public health problem, being in the first 25 causes of death. The present study proposes the use of a widely available laboratory test, of easy use and interpretation, to predict the appearance of complications as pancreatic necrosis. Objective: To determine the usefulness of the serum creatinine as predictive factor of pancreatic necrosis in acute pancreatitis. Materials and Methods: An analytic, transversal and retrospective study. Clinical histories of patients admitted to the “Dr. Miguel Perez Carreño” hospital with a diagnosis of acute pancreatitis between years 2008 and 2009 were reviewed. Serum creatinine was registered and compared according to the Balthazar classification of tomographic severity. Results: The sample was comprised by 50 cases, from which 4 were excluded, due to pregnancy or chronic renal disease. Thirty were female (65%) and 16 male (35%). Between the ages of 18 and 77, with mean age of 40,2. The median hospital stay was 8,74 days. From total of 46 patients, 63% had Balthazar A (n=29); B 17.39% (n=8); C 14,04% (n= 6) and D 6.5% (n=3). No Balthazar E was obtained. When applying a variance analysis, a significant statistical relation was observed, directly proportional to the serum creatinine upon admission (p=0,001) and the 48 hours (p=0,001) with the Balthazar and hematocrit. Conclusions: The evaluation of the levels and variations of serum creatinine is a useful tool for predicting the appearance of pancreatic necrosis in patients with acute pancreatitis.

Keywords : Serum Creatinine; Acute Pancreatitis; Pancreatic Necrosis; Balthazar.