S152 Cirrhosis Exacerbates Multi-System Complications in Acute Pancreatitis: An Insight Into Cardiorenal Syndrome

Introduction: Cardiorenal syndrome, defined by the interconnected dysfunction of cardiac and renal systems, is a critical complication of acute pancreatitis (AP) associated with significant morbidity and mortality. Cirrhosis, characterized by hemodynamic instability and systemic inflammation, may exacerbate these outcomes. However, the specific contribution of cirrhosis to the severity and incidence of cardiorenal syndrome in AP patients remains poorly understood. This study investigates the impact of cirrhosis on cardiac and renal complications in AP, emphasizing the need for tailored therapeutic strategies. Methods: We conducted a retrospective cohort analysis using the TriNetX database, examining 26,160 patients with AP and cirrhosis compared with 26,160 non-cirrhotic AP patients. Primary outcomes included the 1-year incidence of heart failure (HF), acute kidney injury (AKI), and their combined occurrence as an indicator of cardiorenal syndrome. Propensity score matching was utilized to minimize baseline differences. Risk associations were quantified using hazard ratios (HR) with 95% confidence intervals (CI). Results: Cirrhotic AP patients had significantly higher rates of HF (4.8% vs 3.3%; HR: 1.45; CI: 1.32–1.61; P < 0.001) and AKI (27.9% vs 15.9%; HR: 1.76; CI: 1.70–1.82; P < 0.001) compared to non-cirrhotic patients. The co-occurrence of HF and AKI, characteristic of cardiorenal syndrome, was more prevalent in cirrhotic patients (8.2% vs 4.5%; HR: 1.83; CI: 1.65–2.03; P < 0.001). These results align with prior findings highlighting the role of cirrhosis in amplifying systemic inflammation and organ dysfunction in AP. Conclusion: Cirrhosis significantly increases the risk of cardiorenal syndrome in AP patients, underscoring the need for early identification and integrated management of cardiac and renal complications. Interventions targeting hemodynamic stabilization and inflammation modulation may improve outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and refine therapeutic strategies.