Low estimated glomerular filtration rate increases all-cause mortality in acute pancreatitis

Acute pancreatitis (AP) is a common gastrointestinal inflammatory disorder, which is costly and difficult to manage, and there is no pathogenetic treatment. Severe AP may develop in 20% of patients, with a reported mortality rate of 30% due to pancreatic necrosis and organ failure.

BMC anesthesiology reports a study by Fang Gong and team, that aimed to explore the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in acute pancreatitis (AP) admission to intensive care units and found a negative correlation with each other.

This study was a retrospective cohort analysis based on the Medical Information Mart for Intensive Care III database. The eGFR was calculated based on Chronic Kidney Disease Epidemiology Collaboration equation. Cox models with restricted cubic spline functions were used to evaluated the association of eGFR with all-cause mortality.

The key findings of the study are

• The mean eGFR was 65.93 ± 38.56 ml/min/1.73 m2 in 493 eligible patients. 28-day mortality was 11.97% (59/ 493), which decreased by 15% with every 10 ml/min/1.73 m2 increase in eGFR.

• The adjusted hazard ratio (95% confidence interval) was 0.85 (0.76–0.96).

• A non-linear association was proved between eGFR and all-cause mortality. When eGFR < 57 ml/min/1.73 m2, there was a negative correlation between eGFR and 28-day mortality, hazard ratio (95% CI) was 0.97 (0.95, 0.99).

• The eGFR was also negatively correlated with in-hospital and in-ICU mortality. Subgroup analysis confirmed that the association between eGFR and 28-day mortality in different characteristics was stable.

Fang Gong and team concluded that “The eGFR was negatively correlated with all-cause mortality in AP when eGFR is less than the threshold inflection point.”

Reference: Gong, F., Zhou, Q., Gui, C. et al. Association of estimated glomerular filtration rate and all-cause mortality in acute pancreatitis: a retrospective analysis. BMC Anesthesiol 23, 121 (2023). https://doi.org/10.1186/s12871-023-02074-4