Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Demarchi, Ana Carolina dos Santos; Almeida, Cibele Taís Puato de; Ponce, Daniela; Castro, Meire Cristina Novelli e; Danaga, Aline Roberta; Yamaguti, Fábio Akio; Vital, Danielle; Gut, Ana Lúcia; Ferreira, Ana Lúcia dos Anjos; Freschi, Larissa; Oliveira, Juliana Ghisleni de; Teixeira, Ubirajara; Christovan, José Carlos; Grejo, Juliana Rigoto; Martin, Luís Cuadrado

doi:10.3109/0886022x.2013.876353

Cited by 26 publications

(17 citation statements)

References 32 publications

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“… reported a patient with ACS presented with AKI caused by air‐trapping and excessive auto‐positive end‐expiratory pressure during intubation and recovered after extubation. After abdominal surgeries IAH is not rare and measurement of IAP is thought to be a predictor of AKI development for patients followed in intensive care units . Mahajna et al.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury due to abdominal compartment syndrome caused by duodenal metastases of prostate cancer

Gürel

2015

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury due to abdominal compartment syndrome caused by duodenal metastases of prostate cancer

Gürel

2015

Clinical Case Reports

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“…[ 4 10 11 12 ] Demarchi et al recently noted IAP values of >8 mmHg to predict the development of AKI. [ 13 ] Contrastingly, we noted a lack of effect of IAP on early AKI when evaluating the relationship in critically ill obstetric patients. In obstetric patients, it is not established whether the raised IAP values are truly a pathologic elevation or merely a physiological change secondary to the mechanical effects of a growing fetus.…”

Section: Discussionmentioning

confidence: 73%

Role of intra-abdominal pressure in early acute kidney injury: A prospective cohort study in critically Ill obstetric patients

Tyagi

Lahan

Verma

et al. 2018

Indian Journal of Critical Care Medicine

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Aims:This prospective cohort study evaluated intra-abdominal pressure (IAP) and its role in causing acute kidney injury (AKI) in critically ill obstetric patients and utility of urinary neutrophil gelatinase-associated lipocalin (NGAL) to predict AKI.Methods:A total of 50 eligible obstetric patients admitted to our Intensive Care Unit were enrolled and daily IAP measured using indwelling Foley catheter. Early AKI was diagnosed as per the KDIGO criteria and urine assessed for NGAL using ELISA.Results:AKI was seen in 54% and intra-abdominal hypertension (IAH) in 21% patients. In patients with and without AKI, there was statistically similar IAP on day 1 (P = 0.542) and day 2 (P = 0.907) as well as incidence of IAH (19% vs. 23%) (P = 0.766). Area under receiver operating characteristic curve (AUC) for IAP to predict early AKI was 0.499 (95% confidence interval [CI]: 0.325–0.673) (P = 0.992). Urinary NGAL concentration was significantly greater in patients with early AKI compared to those without (P = 0.006); AUC for urinary NGAL to detect early AKI was 0.734 (95% CI: 0.583–0.884) (P = 0.006) and optimal cutoff was 53.7 ng/ml.Conclusions:IAH and AKI are common in critically ill obstetric patients. While IAP does not correlate with early AKI, NGAL is useful to predict AKI.

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“…28,71 Increase in intraabdominal pressure, often caused by an excessive fluid administration or rapid fluid shift, is predictive of postoperative renal impairment. 72,73 The reduction in perfusion pressure is attributed to mechanical compression of renal vasculature, causing a decreasing renal perfusion pressure and inducing renal ischemia. 72,73 Of note, laparoscopic surgery with transient elevations in intraabdominal pressure caused by pneumoperitoneum may result in a clinical decline in urine output, without causing an increase in postoperative acute kidney injury rates.…”

Section: Acute Kidney Injury In Cardiac and Vascular Surgerymentioning

confidence: 99%

Perioperative Acute Kidney Injury

Gumbert

Kork²,

Jackson³

et al. 2020

Anesthesiology

172

113

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Perioperative organ injury is among the leading causes of morbidity and mortality of surgical patients. Among different types of perioperative organ injury, acute kidney injury occurs particularly frequently and has an exceptionally detrimental effect on surgical outcomes. Currently, acute kidney injury is most commonly diagnosed by assessing increases in serum creatinine concentration or decreased urine output. Recently, novel biomarkers have become a focus of translational research for improving timely detection and prognosis for acute kidney injury. However, specificity and timing of biomarker release continue to present challenges to their integration into existing diagnostic regimens. Despite many clinical trials using various pharmacologic or nonpharmacologic interventions, reliable means to prevent or reverse acute kidney injury are still lacking. Nevertheless, several recent randomized multicenter trials provide new insights into renal replacement strategies, composition of intravenous fluid replacement, goal-directed fluid therapy, or remote ischemic preconditioning in their impact on perioperative acute kidney injury. This review provides an update on the latest progress toward the understanding of disease mechanism, diagnosis, and managing perioperative acute kidney injury, as well as highlights areas of ongoing research efforts for preventing and treating acute kidney injury in surgical patients.

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Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Abstract: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Cited by 26 publications

References 32 publications

Acute kidney injury due to abdominal compartment syndrome caused by duodenal metastases of prostate cancer

Acute kidney injury due to abdominal compartment syndrome caused by duodenal metastases of prostate cancer

Role of intra-abdominal pressure in early acute kidney injury: A prospective cohort study in critically Ill obstetric patients

Perioperative Acute Kidney Injury

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