Intra-abdominal hypertension and increased acute kidney injury risk: a systematic review and meta-analysis

Sun, Jing; Sun, Hu; Sun, Zimin; Yang, Xin; Zhou, Shuhua; Wei, Jianxin

doi:10.1177/03000605211016627

Cited by 17 publications

(12 citation statements)

References 22 publications

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“…In recent years, due to the gradual increase in mortality of ACS and IAH, effective treatment of them has attracted increasing attention [1,2]. So far, abdominoplasty is still an effective measure for the treatment of IAH [3]. e therapeutic botulinum toxin type A is artificially extracted from botulinum toxin type A. e efficacy and safety of BoNT-A injection therapy have been affirmed by the academic community and the industry [4,5].…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Type A Injection Improves the Intraperitoneal High Pressure in Rats Treated with Abdominal Wall Plasty

Zhang

Shen

Yang

et al. 2022

Computational Intelligence and Neuroscience

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The aim of the study is mainly to study the subject of BoNT-A injection to improve IAH in rats undergoing abdominal angioplasty. The study problem in surgery, especially in ICU, burn, and trauma centers, intra-abdominal hypertension (IAH), and abdominal compartment syndrome (ACS) are common complications. At present, there are various treatments for IAH. The intramuscular injection of Botulinum toxin type A (BoNT-A) into the abdominal wall has received a lot of attention. Based on this, this study proposes a method for measuring abdominal pressure, applies BoNT-A to reduce abdominal pressure in the IAH state of abdominal wall angioplasty, and explores a way to increase the compliance of the abdominal wall under the premise of maintaining the sealing of the abdominal cavity, so as to realize the expansion of the abdominal cavity. A method is achieved to reduce intra-abdominal pressure and eliminate or alleviate ACS. The results of the experiment showed that when the rats in the control group were injected with the same amount of normal saline as the rats in the experimental group, the IAP was significantly higher than that in the experimental group ( P < 0.05 ). This shows that BoNT-A increases the compliance of the abdominal wall while maintaining the closure of the abdominal cavity, thereby increasing the volume of the abdominal cavity and alleviating the state of IAH in rats.

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Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Type A Injection Improves the Intraperitoneal High Pressure in Rats Treated with Abdominal Wall Plasty

Zhang

Shen

Yang

et al. 2022

Computational Intelligence and Neuroscience

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“…Compared to patients without IAH, patients with IAH had a higher risk of AKI (odds ratio = 2.57, 95% confidence interval: 1.55-4.26, P < 0.001). In the subgroup and meta-regression analyses, body mass index, age, the presence or absence of burns, and cardiac surgery did not affect the risk of AKI [28]. A singlecenter prospective cohort study conducted on 42 patients undergoing cardiac surgery with cardiopulmonary bypass, in whom IAP was measured prior to surgery, immediately after surgery in the operating room and at post-operative 3-6-12-24 h, showed that 83.3% of them developed IAH [29].…”

Section: Intra-abdominal Hypertension and Abdominal Compartment Syndr...mentioning

confidence: 83%

Abdominal compartment syndrome: an often overlooked cause of acute kidney injury

et al. 2022

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Abdominal compartment syndrome (ACS) is defined as any organ dysfunction caused by intra-abdominal hypertension (IAH), referred as intra-abdominal pressure (IAP) ≥ 12 mm Hg according to the World Society of Abdominal Compartment Syndrome. Abdominal compartment syndrome develops in most cases when IAP rises above 20 mmHg. Abdominal compartment syndrome, while being a treatable and even preventable condition if detected early in the stage of intra-abdominal hypertension, is associated with high rates of morbidity and mortality if diagnosis is delayed: therefore, early detection is essential. Acute kidney injury (AKI) is a common comorbidity, affecting approximately one in every five hospitalized patients, with a higher incidence in surgical patients. AKI in response to intra-abdominal hypertension develops as a result of a decline in cardiac output and compression of the renal vasculature and renal parenchyma. In spite of the high incidence of intra-abdominal hypertension, especially in surgical patients, its potential role in the pathophysiology of AKI has been investigated in very few clinical studies and is commonly overlooked in clinical practice despite being potentially treatable and reversible. Aim of the present review is to illustrate the current evidence on the pathophysiology, diagnosis and therapy of intra-abdominal hypertension and abdominal compartment syndrome in the context of AKI.

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“…[ 10 , 15 , 16 ] The meta-analysis recently confirmed that IAH increases AKI risk. [ 17 ] IAH caused reduction in arterial inflow and venous outflow from kidney, then reduction in renal perfusion had developed. Reduction in glomerular hydrostatic pressure from renal hypoperfusion additional with increased Bowman space hydrostatic pressure from intraabdominal hypertension may result in reduction in glomerular filtration gradient which may be the cause of AKI.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal hypertension among medical septic patients associated with worsening kidney outcomes (IAH-WK study)

et al. 2023

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High intra-abdominal pressure (IAP) is associated with acute kidney injury (AKI). However, the relationship between intra-abdominal hypertension (IAH) and AKI in medical septic patients is still inconclusive. This prospective cohort study enrolled patients admitted in the Medical Intensive Care Unit from April 2020 to February 2021. Demographic, therapeutic, and laboratory data were obtained upon admission. The evaluation of IAP was performed via the intra-vesical method during the first and second 24 hours of admission. Kidney function was evaluated on the first 3 days and at least on the 7th day of enrollment. Among 79 patients, 30 (38%) developed IAH, while 50 (63.3%) developed AKI within 7 days. On the first day, the mean IAP was 15.4 (interquartile range [IQR], 4) and 7.0 (IQR, 3.7) mm Hg in the IAH and non-IAH groups, respectively. A total of 52 patients (65.8%) developed the primary outcome (i.e., a composite outcome including AKI, treatment with kidney replacement therapy, or death). On Cox proportional-hazards model between IAH and outcomes, after adjustment for multiple covariates, IAH was associated with a composite outcome (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.3–18.6; P < .005) and the development of AKI (HR, 6.5; 95% CI, 2.3–18.8; P < .005). IAH was associated with a composite outcome of AKI, treatment with kidney replacement therapy, or death in medical septic patients. thaiclinicaltrial.org, Identifier: TCTR20200531001, Registered May 24, 2020.

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Intra-abdominal hypertension and increased acute kidney injury risk: a systematic review and meta-analysis

Cited by 17 publications

References 22 publications

Botulinum Toxin Type A Injection Improves the Intraperitoneal High Pressure in Rats Treated with Abdominal Wall Plasty

Botulinum Toxin Type A Injection Improves the Intraperitoneal High Pressure in Rats Treated with Abdominal Wall Plasty

Abdominal compartment syndrome: an often overlooked cause of acute kidney injury

Intra-abdominal hypertension among medical septic patients associated with worsening kidney outcomes (IAH-WK study)

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