Clinical investigation of hyperamylasemia and amylase·creatinine clearance in patients with chronic hemodialysis
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概要
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To clarify the cause of hyperamylasemia in patients with chronic hemodialysis as well as the clinical meaning of such high values of serum amylase, the activity of serum amylase, total excretion of amylase in the urine, and the amylase-creatinine clearance ratio (CAm/CCr) were measured in patients with chronic renal failure in hemodialysis (and not respectively). It was found that serum amylase elevation was definitely correlated with a decrease of renal function in nearly all the patient. This indicates abnormally high values at or below 20ml/min of creatinine clearance. In cases without hemodialysis, amylase clearance was directly proportional to creatinine clearance, from which it was concluded that excretion of amylase in the urine clearly depends on the renal function. However, in cases with hemodialysis, the CAm/CCr ratio was higher than in non-hemodialyzed patients. Also serum amylase was no higher with anuria than with urinary output. These facts indicate that the calculated creatinine clearance is much in lower hemodialyzed than in non-hemodialyzed patients. Also, in the course of metabolism with catabolism of amylase, certain factors other than excretion from the seem to be involved.Timed measurements of serum amylase aotivity as well as isozyme are important in the diagnosis of pancreatitis in patients with chronic hemodialysis, and high values of CAm/CCr cannot always be considered as sufficient evidence.
- 社団法人 日本透析医学会の論文
社団法人 日本透析医学会 | 論文
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