Continuous renal placement therapy and potential impact on serum lipase and amylase concentrations.

Continuous renal replacement therapy (CRRT) has been used to manage patients with severe pancreatitis and acute renal failure, as well as for those without renal fail- ure, to remove cytokines and other inflammatory mole- cules. It is also commonly used in patients with septic shock and acute renal failure to remove excess fluid and correct electrolyte imbalances. We present a young adult who received CRRT as part of this therapy during care for a critical illness in the Pediatric ICU. During his stay, pancreatitis was diagnosed based on clinical findings and confirmed by plasma values of amylase and lipase. The concentration of amylase and lipase in the ultrafiltrate from CRRT was relatively equal to those noted in the se- rum. We hypothesize that high CRRT clearance of these laboratory parameters may impact their diagnostic utility in pancreatitis. Previous reports of CRRT clearance of other diagnostic laboratory values is presented and the impact of this therapy on the diagnostic values of these values is discussed.