• Kaspar F Bachmann, Adrian Regli, Merli Mändul, Wendy Davis, Reintam BlaserAnnikaADepartment of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland; Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia., and IROI and iSOFA Study Investigators.
• Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland; Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia. Electronic address: kasparfelix.bachmann@gmail.com.
• J Crit Care. 2022 Oct 1; 71: 154078.

PurposeTo assess whether intraabdominal hypertension (IAH) may influence kidney failure as well as mortality.MethodsThis post-hoc analysis of two databases (IROI and iSOFA study) tested the independent association between IAH and kidney failure. Mortality was assessed using four prespecified groups (IAH present, kidney failure present, IAH and kidney failure present and no IAH or kidney failure present).ResultsOf 825 critically ill patients, 302 (36.6%) developed kidney failure and 192 (23.7%) died during the first 90 days. Only 'Cumulative days with IAH grade II or more' was significantly associated with kidney failure (OR 1.29 (1.08-1.55), p = 0.003) while 'cumulative days with IAH grade I or more' (p = 0.135) or highest daily IAP (p = 0.062) was not. IAH combined with kidney failure was independently associated with 90-day mortality (OR 2.20 (1.20-4.05), p = 0.011), which was confirmed for higher grades of IAH (grade II or more) alone (OR 2.14 (1.07-4.30), p = 0.032) and combined with kidney failure (OR 3.25 (1.72-6.12), p < 0.001).ConclusionsThis study suggest that duration as well as higher grades of IAH are associated with kidney failure and may increase mortality.Copyright © 2022 Elsevier Inc. All rights reserved.

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