Discussion
decline in renal function, Coagulation dysfunction, Hyperbilirubinemia, necrotic infection, reperfusion kidney injury, hyperbilirubinemia, intra-abdominal hypertension, abdominal compartment syndrome, AKI
NECROTIZING PANCREATITIS, HYPERBILIRUBINEMIA, COMPLICATION, INTRA-ABDOMINAL HYPERTENSION, ACUTE PANCREATITIS, HYPERBILIRUBINEMIA, ABDOMINAL COMPARTMENT SYNDROME
AKI is a common complication of AP patients. AKI was independently associated with a higher mortality rate in AP patients [An increase in age is associated with a decline in renal function. Patients with acute pancreatitis have a higher incidence rate of developing AKI associated with deterioration of physiological functioning with age [Furthermore, the present study identified hyperbilirubinemia to be an independent risk factor for the early development of AKI in AP patients. Hyperbilirubinemia may induce the formation of reactive oxygen species in mitochondria, damaging the tubular epithelial cells and exacerbating ischemic reperfusion kidney injury [Coagulation dysfunction is an independent risk factor for AKI [The analysis revealed that mechanical ventilation (MV) predicted AKI in AP, which was consistent with findings from a previous study by Shi et al. [Up to one-third of patients with necrotizing pancreatitis develop necrotic infection [Currently, the APACHE II, BISAP, and Ranson scores are clinically used to predict the prognosis of AP patients in the ICU [However, this study had some limitations. First, this study was retrospective, and single-centered. Therefore, future studies should be conducted prospectively in multiple centres to improve clinical utility and external validation, respectively. In addition, the nomogram did not include novel biomarkers or imaging results, which could hinder the performance of the model. The model did not include other factors, such as causes of acute pancreatitis, classification of acute pancreatitis, intra-abdominal hypertension and abdominal compartment syndrome that could potentially affect the development of AKI in AP. Third, the sample size of this study is not large, and only internal verification is used to evaluate the accuracy and effectiveness of the model. Future studies should employ large sample sizes, and include more variables to validate our findings.