P0018 - Multivariate Analysis of Chronic Pancreatitis in Patients With Chronic Kidney Disease

Tyler Grantham, MD¹, Parsia Vazirnia, BS², Radu Grovu, MD¹, Firas Bahdi, MD³, Jean Chalhoub, MD⁴, Danny Issa, MD^5
1Staten Island University Hospital, Staten Island, NY; ²Medical College of Wisconsin, Milwaukee, WI; ³David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA; ⁴Staten Island University Hospital, Northwell Health, Staten Island, NY; ⁵UCLA, Los Angeles, CA

Introduction: Chronic pancreatitis (CP) involves progressive fibrotic destruction of the pancreas in response to chronic inflammation. It has been previously shown that the prevalence of acute pancreatitis is high in patients with end-stage renal disease (ESRD). Additionally, post-mortem studies of patients with ESRD on hemodialysis showed histologic evidence of chronic pancreatitis. Given these previous findings, varying stages of chronic kidney disease (CKD) may pose an increased risk of CP. The aim of this study is to evaluate the association between patients with different stages of CKD and CP.

Methods: Using the Nationwide Inpatient Sample 2018 database, we identified patients with varying stages of CKD utilizing ICD 10 billing codes. Multivariate logistic regression was performed to evaluate the association between different stages of CKD and chronic pancreatitis. Demographic variables including age, race, gender, and income quartile, as well known risk factors for CKD and CP were controlled for by our model of ROC-AUC > 0.85, Hosmer-Lemeshow test >0.1, and R2 >0.8.

Results: A total of 799,646 patients with CKD were identified. Mean age was 70.2 (±14.7) and 53% were males. There was no association with CP found at any stage of CKD or ESRD. In the CKD population, aside from the known risk factors of CP like alcohol use, acute pancreatitis, cholelithiasis and hyperlipidemia, significantly increased odds of CP were found in patients with diabetes mellitus (DM) (OR:1.44, 95% CI 1.36 – 1.54; P< 0.001). Alternatively, aspirin use in CKD patients was associated with significantly lower odds of CP (OR: 0,83, 95% CI 0.76 – 0.9; P< 0.001). Of note, there was no association between coronary artery disease and CP in CKD patients. Black patients with CKD had significantly higher odds of CP.

Discussion: Although previous literature has theorized that CKD poses an increased risk for CP, our study showed that CKD, regardless of its stage, had no association with CP. However, due to a possible combination of genetic and environmental factors that are yet to be understood, certain subsets of CKD patients are at different odds of CP. Black ethnicity and a history of DM could increase the odds of CP in CKD patients as opposed to aspirin use which could have a protective role. Large prospective trials are needed to better evaluate those associations.



Disclosures:


Tyler Grantham, MD¹, Parsia Vazirnia, BS², Radu Grovu, MD¹, Firas Bahdi, MD³, Jean Chalhoub, MD⁴, Danny Issa, MD⁵. P0018 - Multivariate Analysis of Chronic Pancreatitis in Patients With Chronic Kidney Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.