Associations between blood pressure responses to acute stress and impaired renal function and serum uric acid level

Abstract

The study aimed to examine correlations between blood pressure (BP) responses to direct laryngoscopy and tracheal intubation and parameters of renal function, serum uric acid (SUA) level, and mean preoperative BP. Fifty-four patients (≥40 years) who were scheduled for oral surgery were analyzed. General anesthesia was induced by the rapid sequence method without opioid analgesics. Systolic and diastolic BP (SBP, DBP) in the operation room were measured when an electrocardiogram, a BP cuff, and a pulse oximetry probe were attached to the patients (T1) and immediately after the trachea was intubated (T2). The ΔSBP was defined as the difference between SBP at T2 and T1. The increasing rate of SBP (ΔSBP_r) was defined as ΔSBP/SBP at T1. SBP at T2 was associated with increasing age (R = 0.44), serum creatinine (R = 0.32), SUA (R = 0.30), mean preoperative SBP and DBP (R = 0.54 and 0.37, respectively), and reduced estimated glomerular filtration rate (eGFR) (R = −0.44). Serum creatinine and SUA were positively associated, and eGFR was negatively associated with ΔSBP (R = 0.36, 0.34, and −0.29) and ΔSBP_r (R = 0.39, 0.37, and −0.29). Multivariate regression analysis revealed that age and mean preoperative SBP was independently associated with SBP at T2, and serum creatinine was independently associated with ΔSBP and ΔSBP_r. These findings suggested that elevated serum creatinine level, as well as elevated preoperative BP level, was associated with enhanced BP responses to acute stress in middle-aged to elderly patients.

• Baroreflex sensitivity
• blood pressure
• endothelial dysfunction
• hypertension
• tracheal intubation

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This research was supported by a Grant-in-Aid (No. 25463140 to A.K.) for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan.