Clinical and biochemical predictors of acute kidney injury and mortality in acute pancreatitis: Experience from a tertiary hospital in south India

Abstract

Acute kidney injury (AKI) is a frequent and severe complication of acute pancreatitis (AP) associated with high mortality. We retrospectively analysed 129 patients with AP admitted over 10 years to a tertiary hospital. AKI occurred in 53.5% and was linked to greater mortality (37.7% vs. 11.7%, p < 0.001). Compared with non-AKI patients, those with AKI had higher white cell counts and more severe metabolic derangements, including acidosis, hypoalbuminaemia, and electrolyte abnormalities. On multivariable analysis, elevated white cell count, lower serum bicarbonate, and lower systolic blood pressure independently predicted the development of AKI. Among AKI patients, non-survivors showed more profound metabolic derangement and haemodynamic instability. Simple bedside parameters—leucocytosis, metabolic acidosis, hypoalbuminaemia, and hypotension—predicted both AKI and mortality. Early identification and correction of these abnormalities may prevent renal injury and improve survival in AP.