title: Risk factors associated with elevated serum pancreatic amylase levels during hemodialysis.
abstract: Elevated levels of serum pancreatic enzymes are frequently observed in hemodialysis (HD) patients. The complex hemodynamic, biochemical, and physiological alterations in uremia were speculated to cause excessive release of pancreatic enzymes beyond decreased renal clearance. However, hemodynamic factors are seldom explored in this aspect. We performed the study to evaluate the association between intradialytic hemodynamic change and elevated serum pancreatic amylase (SPA). Eighty-three prevalent HD patients without any clinical evidence of acute pancreatitis underwent pre-HD and post-HD blood sampling for serum pancreatic enzyme levels. Demographic, biochemical, and hematological data were collected from patient record review. Hemodialysis information including intradialytic blood pressure changes and ultrafiltration (UF) amount were collected and averaged for 1 month before the blood sampling day. Patients with elevated SPA during the HD session had greater mean systolic blood pressure and mean arterial pressure reduction, greater UF volume, greater pre-HD blood urea nitrogen and serum creatinine, higher serum phosphorus, lower pre-HD serum total CO2, and lower left ventricle ejection fraction (LVEF). Using multivariate linear and logistic regression analysis, the independent predictors of elevated SPA were determined to be mean arterial pressure reduction during HD, mean UF amount, pre-HD serum total CO2, and LVEF. Greater blood pressure reduction during HD, greater UF volume, lower pre-HD serum total CO2, and lower LVEF were significantly associated with elevated SPA during HD. This suggests that hemodynamic factors contribute to elevated serum pancreatic enzymes in HD patients.
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Wu-Chang
authors.initials: WC
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Feng-Ming
authors.initials: FM
authors.lastname: Wang
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Jinn-Yang
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Yee-Yung
authors.initials: YY
authors.lastname: Ng
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Tsai-Hun
authors.initials: TH
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Yao-Ping
authors.initials: YP
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Department of Medicine, Division of Nephrology, Cheng-Hsin General Hospital, Taipei, TaiwanDivision of Nephrology, Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanLo-Sheng Sanatorium Hospital, Taipei, Taiwan.
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000368:Aged; D000681:Amylases / Q000009:adverse effects* / Q000097:blood; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D014462:Ultrafiltration; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D000681:Amylases