The Japanese Journal of Clinical Dialysis Vol.18 No.6(8)

Theme Disease of Liver, Gallbladder, Spleen, and Pancreas in Dialysis Patients
Title Pancreatic abnormalities and pancreatitis in dialysis patients
Publish Date 2002/06
Author Yoshibumi Ubara Kidney Center, Toranomon Hospital
Author Naoki Sawa Kidney Center, Toranomon Hospital
Author Shigeko Hara Kidney Center, Toranomon Hospital
[ Summary ] This report describes 2 patients who developed acute pancreatitis, and whether any factors related dialysis may cause this disease. Case 1 is a patient on CAPD who developed acute pancreatitis five times over a two years period, after being transfered from HD to CAPD. Acute pancreatitis has not occurred since PTMC (percutaneous transmitral valve commurectomy) was carried out for mitral stenosis after a fifth episode of pancreatitis. This clinical course suggests that direct mechanical stimulation, through a constricted mitral valve caused fragmentation and destruction of red blood cells, and that this fragmentation syndrome led to acute pancreatitis. Case 2 is a patient on HD who developed acute pancreatitis during HD.
Intradialytic hemolysis may occur from mechanical trauma to the erythrocytes during passage through the extracorporeal circuit, resulting in acute pancreatitis. In addition to mitral stenosis and an obstructed segment of dialysis tubing, there may be unknown causative factors associated with dialysis.
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