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

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110166
Author(s):  
Jing Sun ◽  
Hongjun Sun ◽  
Zhijian Sun ◽  
Xin Yang ◽  
Shuhua Zhou ◽  
...  

Objective The present meta-analysis aimed to determine the relationship between intra-abdominal hypertension (IAH) and an increased prevalence of acute kidney injury (AKI) and identify the associated risk factors in various patient populations, regardless of whether they were admitted to an intensive care unit. Methods We used three databases for the following search terms: “IAH,” “abdominal compartment syndrome,” “AKI,” “acute kidney failure,” and others. The articles retrieved were compared to identify appropriate studies published until 7 May 2020. The main outcome was AKI. Results Six studies with 344 individuals were included. The patients were divided into two main groups: the IAH and non-IAH groups. Compared with patients without IAH, patients with IAH had a higher risk of AKI (odds ratio = 2.57, 95% confidence interval: 1.55–4.26). 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. Conclusion IAH was associated with AKI risk, and this association was not influenced by age, body mass index, the presence or absence of burns, or cardiac surgery.

2017 ◽  
Vol 8 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Zhouping Zou ◽  
Yamin Zhuang ◽  
Lan Liu ◽  
Bo Shen ◽  
Jiarui Xu ◽  
...  

Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups. The influence of BMI on CS-AKI incidence, duration of hospital, and intensive care unit (ICU) stays as well as AKI-related mortality was analyzed. Results: The mean age of the patients was 53.2 ± 13.9 years. The overall CS-AKI incidence was 33.8% (n = 2,855) with a hospital mortality of 5.4% (n = 154). The incidence of AKI-RRT was 5.2% (n = 148) with a mortality of 54.1% (n = 80). For underweight, normal weight, overweight, and obese cardiac surgery patients, the AKI incidences were 29.9, 31.0, 36.5, and 46.0%, respectively (p < 0.001). The hospital mortality of AKI patients in the 4 groups was 9.5, 6.0, 3.8, and 4.3%, whereas the hospital mortality of AKI-RRT patients in the 4 groups was 69.2, 60.8, 36.4, and 58.8%, both significantly different (p < 0.05). Hospital and ICU stay durations were not significantly different in the 4 BMI groups. Conclusion: The hospital prognosis of AKI and AKI-RRT patients after cardiac surgery was best when their BMI was in the 24-28 range.


2015 ◽  
Vol 17 (2) ◽  
pp. S96-S97
Author(s):  
Zou Zhouping ◽  
Xu Jiarui ◽  
Fang Yi ◽  
Zou Jianzhou ◽  
Ding Xiaoqiang ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Zigang Liu ◽  
Yongmei Zhao ◽  
Ming Lei ◽  
Guancong Zhao ◽  
Dongcheng Li ◽  
...  

Objective: Randomized controlled trials (RCTs) evaluating the influence of remote ischemic preconditioning (RIPC) on acute kidney injury (AKI) after cardiac surgery showed inconsistent results. We performed a meta-analysis to evaluate the efficacy of RIPC on AKI after cardiac surgery.Methods: Relevant studies were obtained by search of PubMed, Embase, and Cochrane's Library databases. A random-effect model was used to pool the results. Meta-regression and subgroup analyses were used to determine the source of heterogeneity.Results: Twenty-two RCTs with 5,389 patients who received cardiac surgery −2,702 patients in the RIPC group and 2,687 patients in the control group—were included. Moderate heterogeneity was detected (p for Cochrane's Q test = 0.03, I2 = 40%). Pooled results showed that RIPC significantly reduced the incidence of AKI compared with control [odds ratio (OR): 0.76, 95% confidence intervals (CI): 0.61–0.94, p = 0.01]. Results limited to on-pump surgery (OR: 0.78, 95% CI: 0.64–0.95, p = 0.01) or studies with acute RIPC (OR: 0.78, 95% CI: 0.63–0.97, p = 0.03) showed consistent results. Meta-regression and subgroup analyses indicated that study characteristics, including study design, country, age, gender, diabetic status, surgery type, use of propofol or volatile anesthetics, cross-clamp time, RIPC protocol, definition of AKI, and sample size did not significantly affect the outcome of AKI. Results of stratified analysis showed that RIPC significantly reduced the risk of mild-to-moderate AKI that did not require renal replacement therapy (RRT, OR: 0.76, 95% CI: 0.60–0.96, p = 0.02) but did not significantly reduce the risk of severe AKI that required RRT in patients after cardiac surgery (OR: 0.73, 95% CI: 0.50–1.07, p = 0.11).Conclusions: Current evidence supports RIPC as an effective strategy to prevent AKI after cardiac surgery, which seems to be mainly driven by the reduced mild-to-moderate AKI events that did not require RRT. Efforts are needed to determine the influences of patient characteristics, procedure, perioperative drugs, and RIPC protocol on the outcome.


2012 ◽  
Vol 3 (4) ◽  
pp. 278 ◽  
Author(s):  
Xue-zhong Xing ◽  
Hai-jun Wang ◽  
Chu-lin Huang ◽  
Quan-hui Yang ◽  
Shi-ning Qu ◽  
...  

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