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The annual incidence of acute pancreatitis (AP) ranges from 4.9 to 73.4 cases per 100,000 worldwide. Patients with end-stage renal disease on dialysis have an increased risk for developing AP compared with patients without renal disease. In addition to the general population risk factors, there are factors related to renal insufficiency and dialysis process that might predispose to AP in this population. Clinical features and diagnosis are the same as those in patients without renal failure; however, amylase and lipase levels should be interpreted cautiously as they might be falsely elevated in renal failure. In this article, we will describe the risk factors that are exclusive to this population. In addition, we will also focus on the laboratory indices and clinical features that are unique to this population with patients with end-stage renal disease.