OBJECTIVES To study the natural course of patients with acute pancreatitis (AP) with acute kidney injury (AKI) and their cytokine profile. METHODS Natural course of patients with AP and AKI was studied in 97 individuals. Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured at presentation and at 72 h in patients who developed AKI. RESULTS Amongst the entire cohort, 16.4% patients developed AKI (persistent AKI - 11 patients, transient AKI - 5 patients). Mortality rate was 25% amongst patients with AKI. Levels of IL-6 (p = 0.035) and IL-8 (p = 0.002) were found to be significantly higher in the AKI group. On multivariate analysis, IL-8 levels at baseline were found to be an independent predictor of AKI. AKI group had significant rise of TNF-α (P < 0.001), IL-6 (P < 0.001) and IL- 1β (P < 0.001) on day 3 whereas persistent-AKI group had significant rise of TNF-α (p = 0.031), IL-6 (p = 0.001) and IL-1β on day 3 and significant decline of IL-10 (p = 0.015). Using a cut-off of 105 pg/ml, IL-8 levels at baseline could predict AKI with a sensitivity of 87.5% and specificity of 59.2%, with area under the curve being 0.744 (p = 0.002). CONCLUSION AP patients developing AKI have poor prognosis. IL-8 levels can predict AKI in patients with AP.

中文翻译：

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急性胰腺炎合并急性肾损伤患者选择性细胞因子的自然病程和特征

目的 研究急性胰腺炎 (AP) 合并急性肾损伤 (AKI) 患者的自然病程及其细胞因子谱。方法 研究了 97 名 AP 和 AKI 患者的自然病程。TNFα、IL-6、IL-10、IL-8 和 IL-1β 水平在发生 AKI 的患者就诊时和 72 小时时进行测量。结果 在整个队列中，16.4% 的患者发生了 AKI（持续性 AKI - 11 名患者，短暂性 AKI - 5 名患者）。AKI 患者的死亡率为 25%。发现 AKI 组的 IL-6 (p = 0.035) 和 IL-8 (p = 0.002) 水平显着更高。在多变量分析中，发现基线 IL-8 水平是 AKI 的独立预测因子。AKI组TNF-α（P < 0.001）、IL-6（P < 0.001）和IL-1β（P < 0. 001)，而持续性 AKI 组在第 3 天 TNF-α (p = 0.031)、IL-6 (p = 0.001) 和 IL-1β 显着升高，IL-10 显着下降 (p = 0.015) . 使用 105 pg/ml 的临界值，基线的 IL-8 水平可以以 87.5% 的灵敏度和 59.2% 的特异性预测 AKI，曲线下面积为 0.744 (p = 0.002)。结论发生 AKI 的 AP 患者预后较差。IL-8 水平可以预测 AP 患者的 AKI。