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• W2912378500 abstract "Introduction: There are few if any published studies investigating the validity of BUN and hematocrit as prognostic indicators in patients with chronic kidney disease (CKD). In this study, we investigated the validity of BUN and hematocrit (Hct) as prognosticators of severity in acute pancreatitis (AP) in the CKD population. Methods: A retrospective cohort study was carried out comparing AP patients with GF <60 (stages 3, 4, ESRD) to matched subjects with GFR>60 (stages 1 and 2). Patient demographics, labs, severity of AP, organ failure, and length of stay (LOS) were extracted from our single-center database of confirmed AP admissions. Dialysis records were obtained from GAIA Software, LLC for patients with stage 4 or ESRD baseline renal function. Subjects who underwent dialysis (intermittent, peritoneal or continuous) within the first 24 hours of their AP admission were excluded. Stratified analysis was performed to see if elevated BUN (admission BUN>20 or increased BUN at 24h) or hematocrit levels (Hct≥44% on admission) were associated with worse outcomes for either of the two GFR groups. Results: A total of 72 subjects with GFR <60 were included in the analysis; 57% of these were stage 3, 8% were stage 4 and 35% were dialysis dependent. Matched controls consisted of 67% stage 2 and 33% stage 1 CKD patients. There were no significant differences in any of the admission characteristics. Subjects with GFR <60 had significantly higher BUN levels and lower Hct levels compared to those with GFR>60. Subjects with GFR <60 were more likely to have moderately severe to severe pancreatitis compared to the GFR>60 group (33 vs 17, P=0.004). In the GFR <60 group, BUN>20 at admission was not associated with severity. However, admitting BUN >20 was predictive of severe pancreatitis in subjects with GFR>60 (P=0.007). In subjects with GFR <60, worse severity ratings and longer LOS were significantly more common in subjects with an upward trend in BUN at 24 hours (14 vs 19, P=0.006; 5.0 vs 7.0, P=0.008). Neither elevated hematocrit levels on admission nor upward trend in Hct were associated with severity or LOS in either group. Conclusion: An upward trend in BUN at 24 hours may be a useful predictor of clinical severity in patients with CKD. Larger study populations and further investigation are needed to evaluate the link between these prognosticators and other outcomes such as pancreatic necrosis in the CKD population." @default.
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• W2912378500 date "2017-10-01" @default.
• W2912378500 modified "2023-10-18" @default.
• W2912378500 title "BUN and Hematocrit as Single-marker Prognosticators for Acute Pancreatitis in Chronic Kidney Disease Patients" @default.
• W2912378500 doi "https://doi.org/10.14309/00000434-201710001-00024" @default.
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