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The Pathogenic Mechanism of Severe Acute Pancreatitis Complicated with Renal Injury: A Review of Current Knowledge

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Abstract

The onset of severe acute pancreatitis (SAP) is clinically harmful as it may rapidly progress from a local pancreatic inflammation into proemial systemic inflammatory reactions. Patients with SAP have a high mortality, with most cases of death resulting from complications involving the failure of organs other than the pancreas. The distinctive feature of SAP is that once it starts, it may aggrevate the clinical condition of the patient continuously, so that the levels of injury to the other organs surpass the severity of the pancreatic lesion, even causing multiple organ failure and, ulitmately, death. In clinical practice, the main complications in terms of organ dysfunctions are shock, acute respiratory failure, acute renal failure, among others. The acute renal injury caused by SAP is not only able to aggravate the state of pancreatitis, but it also develops into renal failure and elevates patients’ mortality. Studies have found that the injury due to massive inflammatory mediators, microcirculation changes and apoptosis, among others, may play important roles in the pathogenic mechanism of acute renal injury.

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Acknowledgements

This work was supported by the technological foundation project of Traditional Chinese Medicine Science of Zhejiang province (No. 2003C130; NO.2004C142), foundation project for medical science and technology of Zhejiang province (No. 2003B134), grave foundation project for technological and development of Hangzhou (No. 2003123B19), intensive foundation project for technology of Hangzhou (NO.2004Z006), foundation project for medical science and technology of Hangzhou (No.2003A004) and foundation project for technology of Hangzhou (No. 2005224).

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  1. Department of General Surgery, Hangzhou First People’s Hospital, Hangzhou, Zhejiang Province, 310006, China

    Xi Ping Zhang

  2. Zhejiang University of Traditional Chinese Medical, Hangzhou, Zhejiang Province, 310053, China

    Lei Wang

  3. Department of Digest, Hangzhou First People’s Hospital, Hangzhou, Zhejiang Province, 310006, China

    Yi Feng Zhou

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  1. Xi Ping Zhang
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  2. Lei Wang
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  3. Yi Feng Zhou
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Correspondence to Xi Ping Zhang.

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Zhang, X.P., Wang, L. & Zhou, Y.F. The Pathogenic Mechanism of Severe Acute Pancreatitis Complicated with Renal Injury: A Review of Current Knowledge. Dig Dis Sci 53, 297–306 (2008). https://doi.org/10.1007/s10620-007-9866-5

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  • DOI: https://doi.org/10.1007/s10620-007-9866-5

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