Comparison of renal function scoring systems with regard to intraabdominal pressure in intensive care patients

Objective: Intra-abdominal pressure (IAB) and intra-abdominal hypertension (IAH) are highly associated with morbidity and mortality in intensive care patients. On the statement accepted at 2004 International Abdominal Compartment Syndrome Consensus Definitions Conference, intra-abdominal pressure is referred as a "steady-state pressure". The increase in intra-abdominal pressure (KIB) creates harmful effects on abdominal organs and other systems. High pressure level longer periods of time causes dysfunction and failure in many organs. In the IAH evaluation algorithm reported in 2007 by the World Society of the Abdominal Compartment Syndrome (WSACS), was defined as IAP being 12 mmHg and above (1). If IAH is not recognized early, it will result in Abdominal Compartment Syndrome (ACS). ACS is a clinical syndrome characterized by an acute and pathological increase of IAP, resulting in mortality if untreated. In our study, we aimed to show whether there is a correlation between the scoring systems of RIFLE, KDIGO and AKIN criteria indicating the stages of kidney failure and IAP. Method: The data of 85 patients who were hospitalized in Gaziantep University Faculty of Medicine Anesthesiology and Reanimation Intensive Care Unit and showed ARF symptoms were scanned retrospectively. Descriptive information (height, weight, BMI, age, gender) were collected from patient charts. Mean values of ARF staging (RIFLE, KDIGO, AKIN), intraabdominal pressures and Apache II scores of patients had measured and recorded daily were obtained. In addition, cases where WSACS stated as a risk factor for IAP (1) were added to statistics as present/absent in patients. Positive correlation between IAP levels and ARF stages of these patients was examined. Findings: A strong positive correlation was found between three ARF stages and mean IAP. In addition, a significant (high) relationship was found between orotracheal intubation (OTE), Trauma and Sepsis, which are among IAP risk factors reported by WSACS, and mean intraabdominal pressure. Meanwhile, it was observed that mean IAP regressed with spontaneous ventilation. Result: In conclusion, it was observed that scoring systems (RIFLE, KDIGO and AKIN criteria) used in staging acute renal failure among patients in intensive care unit have a high level of correlation with mean intraabdominal pressure. Keywords: Acute Kidney Disease, RIFLE, KDIGO, AKIN, intraabdominal pressure, Intensive Care