Correlation between central venous pressure and acute kidney injury in septic patients

  • Ady Sucipto Resident, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Sebelas Maret University– Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia.
  • Septian Adi Permana Anesthesiologist, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Sebelas Maret University – Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia.
DOI: https://doi.org/10.35975/apic.v25i5.1632
Keywords: Acute kidney injury, AKI, Central venous pressure, Fluid therapy, sepsis

Abstract

Background & objective: Sepsis is a medical emergency that requires quick and adequate treatment. In various epidemiological studies it is said that 11–60 % of sepsis patients may suffer from acute kidney injury (AKI). The incidence is 23% in the severe sepsis and 51–64 % in septic shock patients. A number of studies reported that a high value of central venous pressure (CVP) is associated with high incidence and morbidity of AKI in sepsis. We conducted this study to compare a cutoff point of 8 mmHg of CVP with the incidence of AKI in sepsis patients admitted in ICU.

Methodology: This study is an observational analytical cohort prospective study. The sampling was done by consecutive sampling technique. Patients were assigned into 2 groups with each group consisting of 41 samples. CVP measurement was done manually. AKI were assessed by measuring the serum creatinine twice and examining the patient's urine. To analyze the relationship between CVP and the frequency of AKI, chi-square test was performed.

Results: Of the 41 subjects with CVP ≥ 8 mmHg, 29 of them (60.4%) were diagnosed with AKI. Chi-square test revealed a significant correlation between target CVP and AKI incidence (p = 0.025). Also, age, sex, norepinephrine use and type of infection did not correlate with AKI incidence (p > 0.05). The only factor related to AKI significantly was CVP with RR 1.526 (95% CI: 1.04-2.24) and p-value of 0.025

Conclusion: In conclusion, a CVP target value of 8 mmHg or higher has a higher risk of AKI. The use of fluid therapy in managing sepsis requires strict fluid monitoring and evaluation.

Key words: Acute kidney injury; AKI, Central venous pressure; Fluid therapy; sepsis

Citation: Sucipto A, Permana SA. Correlation between central venous pressure and acute kidney injury in septic patients. Anaesth. pain intensive care 2021;25(5):638–642; DOI: 10.35975/apic.v25i5.1632

Received: March 05, 2021, Reviewed: June 14, 2021, Accepted: June 15, 2021

Published
09-30-2021
How to Cite
Sucipto, A., & Permana, S. (2021). Correlation between central venous pressure and acute kidney injury in septic patients. Anaesthesia, Pain & Intensive Care, 25(5), 638–642. https://doi.org/10.35975/apic.v25i5.1632
Issue
Vol 25 No 5 (2021): September-October
Section
ORIGINAL RESEARCH