Intra-abdominal Hypertension Is an Independent Cause of Postoperative Renal Impairment

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Abstract
INTRA-ABDOMINAL pressure (IAP) has become an important issue in the postoperative management of patients undergoing abdominal surgery.1,2 The importance of intra-abdominal hypertension (IAHT) has been heightened by its recognized association with the abdominal compartment syndrome.3,4 For more than a century, it has been recognized that increases in IAP are associated with renal impairment.5-7 To our knowledge, an independent association between renal impairment and IAHT has not been shown previously. While we have previously reported that IAP was associated with a statistically increased odds ratio of developing renal impairment, we did not allow for potentially confounding coexisting predisposing factors for renal failure. Conclusions about the causal role of IAP in renal impairment could not be made from this and other studies.7,8