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Objectives: The inflammatory response is critically important in acute pancreatitis (AP). Systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI), which are novel inflammatory markers, have been linked to determining outcomes in various diseases. The goal of the current study was to examine the relation of the SII index and SIRI with disease severity and acute kidney injury (AKI) in subjects with AP. Methods: A total of 332 subjects with AP were analyzed retrospectively. SII index was calculated using the formula; platelet (P)×neutrophil (N)/lymphocyte (L), while SIRI was calculated as N × monocyte (M)/L count. Multivariate regression (MR) was done to determine the independent risk factors for AKI and severe AP (SAP). Results: Statistical analyses showed that both median SII index and median SIRI increased gradually with higher AP severity (p < 0.001). Both SII index and SIRI were higher in subjects with AKI compared to controls (p < 0.001). Using MR analysis, the SII index was found to independently predict both SAP (OR = 1.004, 95% CI: 1.001–1.008, p = 0.018) and AKI (OR = 1.005, 95% CI: 1.003–1.008, p < 0.001). ROC analysis showed that the SII index could accurately differentiate SAP (AUC = 0.809, p < 0.001) and AKI (AUC = 0.820, p = 0.001) in patients with acute pancreatitis. ROC analysis also showed that SIRI could also accurately differentiate SAP (0.782, p < 0.001) and AKI (AUC = 0.776, p = 0.001). Conclusions: SIRI and the SII indexes can be used as potential biomarkers in predicting both disease severity and AKI development in subjects with AP. [ABSTRACT FROM AUTHOR]

The authors of this letter to the editor respond to a previous study on inflammatory markers in patients with acute pancreatitis. They discuss the use of the systemic immune-inflammation (SII) index and the systemic inflammation response index (SIRI) as potential biomarkers for assessing the severity of acute pancreatitis and the development of acute kidney injury (AKI). The authors also mention a novel index called the Pan-Immune-Inflammation Value (PIV) and compare its effectiveness to the SII and SIRI. They find that the PIV is highly correlated with the SII and SIRI and shows similar associations with disease severity and AKI development. However, the PIV is not superior to the SII and SIRI in predicting these outcomes. The authors suggest further research on more sophisticated indices and the analysis of dynamic changes in the SII and SIRI over time. [Extracted from the article]

Kidney dysfunction is a common and potentially life-threating event in patients with cirrhosis, and underlying mechanisms for renal dysfunction are quite variable. Acute kidney injury (AKI) is relatively frequent encountered in approximately 20% of hospitalized patients with cirrhosis. Nevertheless, chronic kidney disease (CKD) occurs in almost 1% of all patients with cirrhosis. In this review various renal problems encountered in cirrhotic patients are discussed and strategies to prevent renal dysfunction are suggested. [ABSTRACT FROM AUTHOR]