Prediction of kidney damage in the syndrome of intra-abdominal hypertension

  • A.I. Suchodolia
  • K.Yu. Krenov
  • I.V. Loboda
  • V.M. Monastyrskiy
Keywords: intra-abdominal hypertension, abdominal compartment syndrome, renal failure, cystatin C.


The syndrome of intra-abdominal hypertension and abdominal compartment syndrome can complicate the course of many surgical abdominal diseases and lead to the development and progression of multiple organ failure. In particular, impaired renal blood flow is an early and significant pathogenetic link of thanatogenesis in such patients. Mortality at an abdominal compartment syndrome reaches very significant figures — 42–68% and without treatment approaches 100%. The purpose of the work is to predict renal failure in patients with intra-abdominal hypertension syndrome and abdominal compartment syndrome. A survey of 40 patients with acute surgical abdominal pathology and signs of intra-abdominal hypertension was performed. Blood pressure measurement was performed according to the recommendations of the conciliation commission on the problem of intra-abdominal hypertension syndrome (SIGA) from 2004. Also, the calculation of perfusion pressure of the abdominal cavity was performed, which is the difference between mean arterial pressure and intraabdominal pressure. The level of perfusion pressure is less than 60 mm Hg. Art. correlates with survival of patients. Determination of cystatin C was performed in the first 48 hours after hospitalization of patients in VAIT. The calculation of the results was carried out according to the standard t-criterion calculation formulas in the Exel tables. It was found that of 40 patients died — 13, and survived — 27. The reliable difference between the indicators of intra-abdominal pressure in surviving and deceased patients was acquired only at the end of the third day of observation, whereas the abdominal perfusion pressure indices significantly differed already in the first day. In the analysis of cytatine C in surviving patients, the biomarker values were 1,299±0.827, whereas in those who died 1,882±0.828, the statistical deviation was significant at p≤0.05. Thus: the cytosine C score, in combination with the dynamics of abdominal perfusion tick, can be considered as a marker that may predict the development of renal insufficiency in patients with SIGA-AKS.


1. Bodiaka, V. Yu., Ivashchuk, O. I. & Vlasov, V. V. (2012). Rol vnutrishnocherevnoi hipertenzii v rozvytku pechinkovo-nyrkovoi dysfunktsii pislia modeliuvannia ta operatyvnoho likuvannia hostroi khirurhichnoi patolohii orhaniv cherevnoi porozhnyny [The role of intraperitoneal hypertension in the development of hepatic renal dysfunction after modeling and surgical treatment of acute surgical pathology of abdominal cavity organs]. Shpytalna khirurhiia – Hospital Surgery, 3, 57–59.

2. Ershov, A. V. & Dolgih, V. T. (2015). Kompartment-sindrom pri eksperimentalnom ostrom destruktivnom pankreatite [The compartment syndrome in experimental acute destructive pancreatitis]. Sibirskij medicinskij zhurnal – Siberian Medical Journal, 5, 22–27.

3. Morar, I. K., Ivashchuk, O. I., Davydenko, I. S., Riabyi, S. I. & Vitkovska, S. V. (2012). Vplyv vnutrishnocherevnoi hipertenzii na patomorfolohichni osoblyvosti perebihu hostroho destruktyvnoho pankreatytu v eksperymenti [Influence of intraperitoneal hypertension on the pathomorphological features of the course of acute destructive pancreatitis in the experiment]. Patolohiia – Pathology, 2, 95–97.

4. Timberbulatov, Sh. V., Kayumov, F. A., Fayazov, R. R., Smyr, R. A. & Timberbulatov, V. M. (2015). Patomorfologiya sindroma intraabdominalnoj gipertenzii [Pathomorphology of the syndrome of intra-abdominal hypertension]. Medicinskij vestnik Bashkortostana – Medical Bulletin of Bashkortostan, 10, 5 (59), 54–60.

5. Khomiak, I. V., Furmanov, Yu. O., Savytska, I. M., Kit, O. V. & Khomiak, A. I. (2015). Vplyv pidvyshchenoho vnutrishnocherevnoho tysku na vynyknennia poliorhannoi nedostatnosti pry hostromu pankreatyti [Influence of increased intraabdominal pressure on the occurrence of multiple organ failure in acute pancreatitis]. Klinichna khirurhiia – Clinical Surgery, 10, 77–79.

6. Acute kidney injury. Management of acute kidney injury: the role of fluids, e - alerts and biomarkers. UK consensus conference, Friday 16−Saturday 17 November 2012, Edinburgh. Royal College of Physicians of Edinburgh, 42 (19), 50.

7. Akbulut, G. Aktepe, F., Altindis, M. & Serteser, M. (2010). Renal cytokine and histopathologic changes following acutely increased intra-abdominal pressure: an animal study. Ulus Trauma Acii Cerrahi Derg, 16 (2), 103–107. Retrieved from

8. Futrakul, N. & Futrakul, P. (2017). Biomarker for early renal microvascular and diabetic kidney diseases. Ren Fail., 39 (1), 505–511. doi: 10.1080/0886022X.2017.1323647.

9. Ho, J., Tangri, N., Komenda, P., Kaushal, A., Sood, M., Brar, R. … Rigatto, C. (2015). Urinary, Plasma, and Serum Biomarkers' Utility for Predicting Acute Kidney Injury Associated With Cardiac Surgery in Adults: A Meta-analysis. Am. J. Kidney Dis., 66 (6), 993–1005. doi: 10.1053/j.ajkd.2015.06.018.

10. Schley, G., Koberle, C., Manuilova, E., Rutz, S., Forster, C., Weyand, M. & Carsten, W. (2015). Comparison of plasma and urine biomarker performance in acute kidney injury. PLOS ONE, 10 (12), e0145042. doi: 10.1371/journal.pone.0145042.

11. Schmid, M., Dalela, D., Tahbaz, R., Langetepe, J., Randazzo, M., Dahlem, R. … Chun, F. K-H. (2015). Novel biomarkers of acute kidney injury: Evaluation and evidence in urologic surgery. World Journal of Nephrology, 4 (2), 160–168. doi: 10.5527/wjn.v4.i2.160.

12. Shlipak, M. G., Coca, St. G., Wang, Zhu, Devarajan, P., Koyner, J. L., Patel, U. D., … Parikh, C. R. (2011). Presurgical serum cystatin C and risk of acute kidney injury after cardiac surgery. American Journal of Kidney Diseases, 58 (3), 366–373. doi: 10.1053/j.ajkd.2011.03.015.

13. Wang, X., Che, M., Xie, B., Xue, S. & Yan, Y. (2014). Preoperative serum cystatin C combined with dipstick proteinuria predicts acute kidney injury after cardiac surgery. Ren Fail., 36 (10), 1497–503. doi: 10.3109/0886022X.2014.949759.
How to Cite
Suchodolia, A., Krenov, K., Loboda, I., & Monastyrskiy, V. (2018). Prediction of kidney damage in the syndrome of intra-abdominal hypertension. Reports of Vinnytsia National Medical University, 22(4), 669-673.