Correlation Between Raised Intra-abdominal Pressure And Acute Renal Failure In Patients With Severe Pancreatitis

Objective:To study the correlation between raised intra-abdominal pressure and acute renal failure in patients with acute severe pancreatitis, define the link, occurrence and development of them, provide a new theoretical basis and clinical thinking for clinicians in the treatment of patients with severe pancreatitis and acute renal failure, and facilitate the timely choice of reasonable decompression manner in the treatment in order to reduce the mortality, save patient’s hospitalization costs and shorten hospital stay.Methods:A retrospective analysis was conducted on patients with acute severe pancreatitis who were admitted into the First Affiliated Hospital of Kunming Medical University from March2009to March2014. The clinical data of60patients with severe pancreatitis were included according to the exclusion criteria. The "intra-abdominal pressure" and "renal function" were recorded for each patient. The selected patients were divided into two groups according to with or without raised intra-abdominal pressure on admission, including the "decreased intra-abdominal pressure group" and "raised intra-abdominal pressure group", and the renal function values were compared. When the intra-abdominal pressure got stabilized again in the raised intra-abdominal pressure group which underwent percutaneous puncture and pancreatic ascites drainage and decompression, the renal function values were collected and compared with those prior to the decompression therapy. Finally, the renal function values in patients underwent decompression were compared with those in patients in the decreased intra-abdominal pressure group.Results:The indexes of renal function in the raised intra-abdominal pressure group were significantly worse than those in the decreased intra-abdominal pressure group (P<0.01). The indexes of renal function after decompression were significantly better than those before decompression in patients in the raised intra-abdominal group (P<0.01). However, the indexes of renal function after decompression in the raised intra-abdominal group were still worse than those in the decreased intra-abdominal pressure group (P<0.05).Conclusion:During the occurrence of acute pancreatitis, the raised intra-abdominal pressure is a high risk single factor high of acute renal failure, showing an obvious positive correlation. The changes of intra-abdominal pressure in patients with severe pancreatitis were closely and continuously monitored, and the patients underwent timely intra-abdominal decompression (such as percutaneous puncture and pancreatic ascites drainage and decompression) depending on intra-abdominal pressure values, with relatively important clinical significances in prevention and mitigation of severe pancreatitis complicated by acute renal failure.