[Uremic pancreopathy. Clinical and experimental studies of its pathogenesis].

Uremia results in complex metabolic disturbances of exocrine pancreatic function which increase with the severity of renal insufficiency. This uremic pancreopathy is not identical with the pancreatitis of classical type. Its important clinical indicator is an elevation of serum lipase activity (more than 60% in nondialyzed renal insufficiency; hyperlipasemia was also detectable in chronic hemodialyzed patients (45%). The pathogenesis is heterogenous, its concept based on clinical and experimental studies involves several components: hormonal alterations (calcitonin etc.), catabolic protein metabolism in uremia, systemic disturbances (hemodynamics, hypoxia, acidosis etc.), direct impairment of the pancreatic cells induced by uremic toxins.