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In cases of acute pancreatitis (AP), hematocrit (Hct) levels >44% are associated with the development of pancreatic necrosis. However, many AP patients with elevated Hct levels do not develop necrosis (such elevation has a positive predictive value ranging from 21% to 68%). A research group from Pittsburgh hypothesized that severe intravascular volume depletion also affects the kidneys, resulting in an increase in serum creatinine (Cr) levels. Might elevated Cr levels be a better marker of pancreatic necrosis than elevated Hct levels?
To find out, researchers studied 129 patients with AP, most of whom underwent a contrast-enhanced abdominal computed tomography scan within 24 hours of admission and had their Hct, blood urea nitrogen (BUN), an…