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

Figures & data

Figure 1. ROC curve presenting the first intra-abdominal pressure in the first day in regard of acute kidney injury development; AUC: area under ROC curve; CI: confidence interval.

Table 1. Serial evaluation of IAP, considering average and maximum values for the prediction of AKI.

			CI 95%
	AUC	p	Under	Upper
IAP max d1	0.630	0.086	0.486	0.774
IAP mean d1	0.621	0.110	0.477	0.765

Notes: AUC, area under the ROC curve; CI95%, confidence interval 95%; IAP, intra-abdominal pressure; IAP max d1, IAP maximum value on the first day after surgery; IAP mean d1, intra-abdominal value on the first day after surgery.

Table 2. Clinical characteristics in according to occurrence of acute kidney injury.

	With AKI (n = 26)	Without AKI (n = 34)	p
Age (years)	64.89 ± 13.7	55.8 ± 16.1	0.025
Male (%)	13 (50)	22 (64.7)	0.378
APACHE II	14 ± 6	11 ± 4	0.024
BMI (kg/m^2)	26 ± 5.0	25 ± 4.0	0.393
Type of surgery
Bowel surgery (%)	15 (58)	14 (41)
Surgery liver/gallbladder (%)	7 (27)	5 (14.7)
Stomach surgery (%)	2 (8)	9 (26.4)
Pancreas surgery (%)	2 (8)	6 (17.6)	0.119
Character of surgery
Character Elective (%)	7 (27)	17 (50)
Character urgencial (%)	7 (27)	7 (20.5)	0.188
Character Emergency (%)	12 (46)	10 (29.4)
Duration of surgery (h)	3.3 ± 1.91	4.3 ± 2.75	0.133
Abdominal tumor (%)	10 (38)	18 (52)	0.394
Mechanical ventilation (%)	16 (61)	15 (44)	0.281
Volume received (L)	7.2 ± 3.7	7.8 ± 3.1	0.497
Urinary output (L)	1.7 ± 0.87	3.3 ± 2.2	0.001
MBPmin (mmHg)	78 ± 19.3	84 ± 12.1	0.146
MBPmax (mmHg)	86 ± 15.2	92 ± 12.2	0.095
IAP1 (mmHg)	11.0 ± 4.51	8.8 ± 4.98	0.090
IAH (%)	11 (42)	5 (19)	0.035
Duration of the follow-up	1.0 (1.0–2.0)	2.0 (1.0–3.0)	0.235
SIRS (%)	10 (38)	18 (52)	0.394
Septic shock(%)	10 (38)	13 (38)	0.803

Notes: AKI, acute kidney injure; APACHE II, Acute Physiological and Chronic Health Evaluation II; BMI, Body Mass Index; MBP_min, minimum mean blood pressure; MBP_max, maximum mean blood pressure; SIRS, systemic inflammatory response syndrome.

Table 3. Association between IAH and AKI in patients submitted to abdominal surgery.

			CI 95.0%
	p	OR	Lower	Upper
IAH	0.049	3.627	1.002	13.125
Age (years)	0.151	1.030	0.989	1.071
APACHE II	0.122	1.098	0.975	1.237

IAH, intra-abdominal hypertension; AKI, acute kidney injure; CI 95%, confidence interval 95%; APACHE II, Acute Physiological and Chronic Health Evaluation II.