Diagnostic Accuracy of Intra-Abdominal Pressure Measurement Method via Bladder in Predicting Renal Dysfunction after Kidney Transplantation

Background: The patients undergoing kidney transplantation are exposed to Intra-Abdominal Pressure (IAP) elevation following a surgery.Aim: The present study aimed to evaluate the diagnostic accuracy of the IAP measurement method via bladder in the prediction of renal dysfunction after kidney transplantation.Method: This longitudinal study was conducted on ۱۳۵ kidney transplant patients in two hospitals in Iran/Afghanistan from February ۲۰۱۹ to the end of October ۲۰۱۹. The patients' IAP was measured by nurses every ۶ h up to ۲۴ h after the surgery. The indices of renal dysfunction were utilized, including creatinine increase and urine reduction. Doppler ultrasound was used as a golden standard diagnostic test. Data were analyzed in STATA ۱۴.Results: Out of ۱۳۵ patients, an increase in IAP>۱۰ mmHg was observed in ۹.۵% of cases. Urinary loss and creatinine decrease more than ۲۵% of baseline indicated a significant correlation with IAP mean difference (P=۰.۰۰۱) (۴-۱). Therefore, IAP could predict renal dysfunction based on the reduction of urinary volume and a decrease in creatinine of more than ۲۵% of baseline. Finally, a comparison between the diagnostic power of the IAP measurement method and Doppler ultrasound indicated ۹۰% of sensitivity and ۹۴% of negative predictive value in predicting renal dysfunction.Implications for Practice: As evidenced by the obtained results, the IAP measurement via bladder catheter might be a primary test to predict renal dysfunction before Doppler ultrasound; nonetheless, further research is required.

کلیدواژه ها:

: Intra-abdominal pressure (IAP) ، Kidney Transplantation ، Renal dysfunction