Indian journal of Medical Biochemistry

Register      Login

VOLUME 23 , ISSUE 3 ( September-December, 2019 ) > List of Articles

RESEARCH ARTICLE

Pancreatic Enzymes in End-stage Renal Disease Patients on Maintenance Hemodialysis

Taoufiq Aatif, Rachid Akka

Keywords : Amylase, End-stage renal disease, Hemodialysis, Lipase, Pancreatic enzymes

Citation Information : Aatif T, Akka R. Pancreatic Enzymes in End-stage Renal Disease Patients on Maintenance Hemodialysis. Indian J Med Biochem 2019; 23 (3):343-346.

DOI: 10.5005/jp-journals-10054-0119

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Elevated serum levels of pancreatic enzymes are frequently observed in end-stage renal disease (ESRD) in the absence of pancreatic diseases. Aim: Evaluate the prevalence of elevated pancreatic enzymes in patients on maintenance hemodialysis (HD) and compare it with healthy controls. Materials and methods: Serum amylase (SA) and serum lipase (SL) levels were evaluated in 20 patients on maintenance HD (group I) and compared with levels in 25 healthy controls (group II). Results: In group I, hyperamylasemia and/or hyperlipasemia were found in 14 (70%) patients. Abnormal levels of both SA and SL simultaneously were noted in 7 (35%); however, hyperamylasemia and hyperlipasemia only were noted, respectively, in 11 (55%) and in 10 (50%) patients. There was a significant moderate positive correlation between SA and serum creatinine (103.8 ± 50.6 vs 89.9 ± 20.9; r = 0.48; p = 0.029), and between SL and serum creatinine (61.2 ± 40.1 vs 89.9 ± 20.9; r = 0.47; p = 0.034) in group I. Mean SA values were significantly higher in group I in comparison with group II: 103.8 ± 50.6 vs 64.1 ± 31.5 U/L; p = 0.005, and mean SL values were significantly higher in group I in comparison with group II: 61.2 ± 40.1 vs 31.8 ± 17.7 U/L; p = 0.002. Conclusion: Our results indicate that elevated serum levels of pancreatic enzymes in ESRD patients on maintenance HD is slight but frequently occurs. There is a general agreement that reduced glomerular filtration rate would be the cause. The occurrence of hypothetical concomitant pancreatic damage has been suggested and the complex hemodynamic, biochemical, and physiological alterations in uremia were speculated to cause an excessive release of pancreatic enzymes.


PDF Share
  1. Masoero G, Bruno M, Gallo L, et al. Increased serum pancreatic enzymes in uremia: Relation with treatment modality and pancreatic involvement. Pancreas 1996;13:350–355. DOI: 10.1097/00006676-199611000-00004.
  2. Jiang CF, Ng KW, Tan SW, et al. Serum level of amylase and lipase in various stages of chronic renal insufficiency. Zhonghua Yi Xue Za Zhi (Taipei) 2002;65:49–54.
  3. Lin XZ, Chen TW, Wang SS, et al. Pancreatic enzymes in uremic patients with or without dialysis. Clin Biochem 1988 Jun;21:189–192. DOI: 10.1016/0009-9120(88)90009-4.
  4. Vaziri ND, Chang D, Malekpour A, et al. Pancreatic enzymes in patients with end-stage renal disease maintained on hemodialysis. Am J Gastroenterol 1988;83(4):410–412.
  5. Bailey GL, Katz AI, Hampers CL, et al. Alterations in serum enzymes in chronic renal failure. JAMA 1970;213:2263–2265. DOI: 10.1001/jama.1970.03170390053014.
  6. Salt W, Schenker S. Amylase-its clinical significance, a review of literature. Medicine (Baltimore) 1976 Jul;55(4):269–289. DOI: 10.1097/00005792-197607000-00001.
  7. Tietz NW, Shuey DF. Lipase in serum – the Elusive enzyme, an overview. Clin Chem 1993;39(5):746–756.
  8. Usha Rani S, Rama Rao J, Ambica Devi K. Effect of renal insufficiency on pancreatic enzyme activities in serum. J Sci 2015;5(4):232–234.
  9. Thierry FX, Dueymes JM, Vernier I, et al. Serum lipase and amylase levels in chronic renal failure: interpretation of results-effects of extrarenal purification. Nephrologie 1988;9(6):263–267.
  10. Koizumi M, Takada T, Kawarada Y, et al. JPN Guidelines for the management of acute pancreatitis: Diagnosis criteria for acute pancreatitis. J Hepatobiliary Pancreat Surg 2006;13:25–32. DOI: 10.1007/s00534-005-1048-2.
  11. Bastani B, Mifflin TE, Lovell MA, et al. Serum amylases in chronic and end-stage renal failure: Effects of mode of therapy, race, diabetes and peritonitis. Am J Nephrol 1987;7:292–299. DOI: 10.1159/000167488.
  12. Chen Y-H, Yang W-C, Wang F-M, et al. Risk factors associated with elevated serum pancreatic amylase levels during hemodialysis. Hemodial Int 2011;15:79–86. DOI: 10.1111/j.1542-4758.2010.00519.x.
  13. Berk JE, Fridhandler L, Ness RL. Amylase and iso-amylase activities in renal insufficiency. Ann Intern Med 1979;90:351–353. DOI: 10.7326/0003-4819-90-3-351.
  14. Sommer H, Kasper H, Fosel T. Serum lipase activity in chronic renal failure. Acta Hepatogastroenterol (Stuttg) 1975;22:248–252.
  15. Zachee P, Lins RL, De Broe ME. Serum amylase and lipase values in acute renal failure. Clin Chem 1985;31:1237.
  16. Gross JB, Parkin JW, Maher RT, et al. Serum amylase and lipase values in renal insufficiency. Ann Intern Med 1979;90:351–353. DOI: 10.7326/0003-4819-90-3-351.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.