Elevated Serum Pancreatic Enzymes in a Patient With Acute Epigastric Pain and End-Stage Renal Disease

Acute pancreatitis is one of the most common diagnoses for patients admitted to the hospital with acute abdominal pain and nausea and vomiting. often elevated amylase and lipase support the diagnosis. This case illustrates the importance of recognizing the elevated laboratory findings seen in patients with end-stage renal disease, especially those laboratory findings that aid in making clinical decisions and/or establishing the diagnoses. We present a case of a patient misdiagnosed with recurrent acute pancreatitis due to his recurrent episodes of nausea, vomiting, abdominal pain, and persistently elevated pancreatic enzymes in the setting of end-stage renal disease. It is important for clinicians to recognize that these enzymes are renally eliminated and thus will be elevated as a result of the renal disease, which would limit the use of pancreatic enzymes to establish the diagnosis of acute pancreatitis.