Prevalence and Correlation of Intra-abdominal Hypertension with Incidence of Acute Kidney Injury in ICU Patients: A Cohort Study from A Tertiary Care Centre

Abstract

Introduction: Intra-abdominal hypertension (IAH), a sustained and repeated steady state rise in intra-abdominal pressure (IAP) above 12 mmHg, was reported as a hidden cause contributing to morbidity and mortality in critically ill patients. This study was aimed to find out the possible relationship between IAH and acute kidney injury (AKI) in ICU patients. Material and methods: Prospective cohort study was conducted among patients admitted in medical and surgical ICU. Consecutive patients coming under the inclusion criteria were selected and IAH was measured using pressure transducer technique. IAP was measured at the time of admission, at 24 hours, 48hours and also at the end of 72hours. Other parameters were collected based on a standard proforma prepared. Results: Eighty patients were included in our study, of which 24 patients had IAH. Mean age in patients with IAH was obtained as 63.08 ± 12.37 years with a male predominance. Maximum patients were belonging to age group of 61-70 yrs (25%), 9 patients were below 40 yrs and 14 patients were above 81yrs. Mean IAP was calculated to be 11.65 ± 3.15. Only 9 patients were in grade IV (11.3%). Risk factors associated were found to be ascites, upper GI bleed and metabolic encephalopathy. IAH and AKI were found to be significantly correlated (odds ratio=2.666 with CI 0.98-7.25). Conclusion: Rising intra-abdominal pressure is found to have higher incidence of renal failure than those with established IAH. IAH has been found to be a clinically significant risk factor for development of AKI in ICU patients.