[Effect of chronic renal failure and hemodialysis on the pancreas-specific enzyme pattern in the serum].
Amylase concentration in serum is frequently found increased in chronic renal insufficiency without being associated with pancreatic diseases. A prospective study was performed in 71 patients with chronic renal insufficiency undergoing hemodialysis for comparison of different pancreatic enzymes in serum. 7 patients were not considered in this comparative study because of chronic pancreatitis-like-changes in ultrasound. Increased serum concentrations were found for total amylase in 27 patients (42.2%), pancreatic amylase in 26 patients (25.0%), lipase in 50 patients (78.1%), immunoreactive trypsin in 61 patients (95.3%) and for elastase 1 in 7 patients (10.9%). Hemodialysis did not affect any of the investigated pancreatic serum-enzymes. Elastase 1 determination in serum appears superior to the other pancreatic serum-enzymes because of higher specificity, not limited by renal insufficiency. The different serum concentration of elastase 1 and trypsin, which have a similar molecular weight, points towards a completely different clearance mechanism for these enzymes.
Abteilung Innere Medizin II und Gastroenterologie, Universität Ulm.
A
A
Stanescu
D
D
Mayer
J
J
Rosenthal
P
P
Malfertheiner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000201:enzymology*; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology*; D010196:Pancreatic Elastase / Q000097:blood*; D010186:Pancreatic Function Tests; D010195:Pancreatitis / Q000201:enzymology; D006435:Renal Dialysis; D014357:Trypsin / Q000097:blood*; D014463:Ultrasonography
D008049:Lipase; D000681:Amylases; D010196:Pancreatic Elastase; D014357:Trypsin
Einfluss der chronischen Niereninsuffizienz und Hämodialyse auf das Pankreasspezifische Enzymmuster im Serum.