Human pancreatic amylase and lipase serum levels in children and adolescents with chronic renal failure

摘要

Chronic renal failure (CRF) impairs homeostasis in many ways. Pancreas is one of the organs affected in the course of CRF. Gastrointestinal symptoms (nausea, abdominal pain, vomits) are often in CRF, but may be also caused by pancreatitis. The diagnosis of pancreatitis is more difficult in CRF patients because of the non-specific elevation of the serum activity of pancreatic enzymes observed during CRF. The aim of this study was to evaluate serum concentrations of human pancreatic amylase (h-p-A) and human pancreatic lipase (h-p-L) in CRF children and adolescents without clinical symptoms of pancreatitis treated conservatively and on chronic dialysis. The study was performed on 46 children and adolescents aged 1-26 yr. : 22 patients treated conservatively, aged 1-18 yr. (gr. I), 7 patients on continuous peritoneal dialysis, aged 2-18 yr. (gr. II) and 17 patients on hemodialysis aged 13-26 yr (gr. III). Control group consisted of 21 children aged 7-17 yr. Enzymes were assayed using immunoenzymatic test (ELISA). In all groups of children with CRF h-p-A and h-p-L values were significantly elevated comparing to the control group. There was no statistically significant differences between groups I, II and III, but the highest values both of enzymes was observed in children treated conservatively. In summary, the results show, that the non-specific elevation of serum h-p-A and h-p-L concentration occurs in CRF children and adolescents, and suggest that the usefulness of these enzymes for diagnostic of pancreatitis is limited.