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AKI Secondary to Pancreatitis — ESENeph MCQ

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ModerateAcute Kidney InjuryAKI Secondary to PancreatitisESENeph

A 40-year-old man presents with acute pancreatitis, lipaemia retinalis, and a triglyceride level of 55 mmol/L. His creatinine is 180 umol/L (baseline 85 umol/L). What is the underlying cause of the AKI?

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Correct answer: B — Severe hypertriglyceridaemia causing pancreatitis and secondary AKI from hypovolaemia and third-spacing

Severe hypertriglyceridaemia (>11.2 mmol/L) is a cause of acute pancreatitis. The AKI is most commonly secondary to pancreatic inflammation, hypovolaemia from third-spacing, and systemic inflammatory response. There is no direct triglyceride nephrotoxicity. Management priorities are treating the pancreatitis, aggressive IV fluid resuscitation, and addressing the hypertriglyceridaemia (insulin/dextrose infusion, fibrates when oral intake resumes).

Reference: NICE NG104 2018 – Pancreatitis; KDIGO 2012 – AKI