AKI IN ICU PATIENTS AND ITS POSSIBLE RELATION TO INTRA-ABDOMINAL HYPERTENSION.

Objective:- Increase in intra-abdominal pressure (IAP) is a clinical condition developed by approximately half of Intensive Care Unit (ICU) patients. This study aimed to investigate the possible relationship between intra-abdominal hypertension and AKI in ICU patients. Patients and methods:- this study was a cross-sectional observational study, in which 40 patients were included and divided into 2 groups: Group 1: 20 patients having AKI and Group 2: 20 patients with no AKI for whom IAP was measured as a control. Renal function was evaluated according to the Acute Clinical Practice Guidelines for AKI. Intravesical pressure measurement was done as a reflection for intra-abdominal pressure on admission to the ICU and 48 hours after. Results:- The mean IVP on ICU admission was 14.85 ± 1.28 mmHg and 7.57±2.39 mmHg in groups 1 and 2 respectively, the difference between the two groups was statistically significant (p= 0.00); whereas the mean intra-vesical pressure after 48 hours from ICU admission was 20.20±1.73mmHg and 10.30±3.25mmHg in groups 1 and 2 respectively and the difference was also statistically significant (p value=0.00). ROC curve analysis has shown that both admission and follow up IVPs had the same diagnostic criteria with the same AUC (0.994); but admission IVP had two advantages; predicting AKI at lower value (11.0 mmHg versus15.0 mmHg for IVP-1) and also earlier prediction of AKI. Conclusion:- IAH is a frequent finding in ICU patients having AKI. Measurement of intra-vesical pressure upon ICU admission can predict the occurrence of AKI.