Pathophysiology and management of acute kidney injury in the setting of abdominal compartment syndrome.
Abdominal compartment syndrome (ACS) is defined as an organ dysfunction caused by intra-abdominal hypertension (IAH). Up to 4.2% of the patients in intensive care unit may develop IAH with it being an independent predictor of mortality. However, overall, it still remains a relatively underdiagnosed condition, part in because physical examination alone is very unreliable. Acute kidney injury is one of the most consistently described organ dysfunctions with oliguria being one of the earliest clinical signs of IAH. We recommend that any patient with evidence of new onset oliguria in the setting of distended abdomen, unexplained respiratory failure, with or without hypotension should be suspected of having IAH/ACS. Intravesicular pressure measurement represents a safe, rapid, and cost-effective method of diagnosing IAH. We hereby review the pathophysiology, diagnosis, and management of ACS and its association with acute kidney injury.
1Division of Nephrology, Departments of 2Medicine and 3Pathology, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians & Surgeons, New York, NY.
Gagangeet
G
Sandhu
Pavan
P
Mankal
Isha
I
Gupta
Aditi
A
Ranade
Anip
A
Bansal
James
J
Jones
D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D009846:Oliguria / Q000175:diagnosis / Q000209:etiology*