Impact of blood pressure variability on occurrence of acute kidney injury in patients with hypovolemic shock
10.3969/j.issn.1671-8283.2024.12.001
- VernacularTitle:血压变异性对低血容量性休克患者急性肾损伤发生的影响
- Author:
Meng YANG
1
;
Qiuxiang HU
1
;
Xiaojuan LAI
1
;
Yanmei HUANG
1
Author Information
1. 中山大学附属第一医院急诊科,广东 广州,510080
- Publication Type:Journal Article
- Keywords:
blood pressure variability;
acute kidney injury;
hypovolemic shock;
retrospective cohort study;
MIMIC-Ⅳ database
- From:
Modern Clinical Nursing
2024;23(12):1-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between the variability of blood pressure and the occurrence of acute kidney injury(AKI)in patients with hypovolemic shock so as to provide a theoretical basis for early prediction and prevention of AKI.Methods Clinical data of 661 critically ill patients with hypovolemic shock were acquired from the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database from 2008 to 2022.Data were grouped with the quartile division method,with systolic blood pressure average real variability(SBP-ARV)and diastolic blood pressure average real variability(DBP-ARV)as the continuous or categorical variables.Univariate and multivariate logistic regression analyses were used to examine the relationships of SBP-ARV and DBP-ARV with the occurrence of AKI.Additionally,the relationship between SBP-ARV and the occurrence of AKI was further investigated in subgroups of gender,age,sequential organ failure assessment(SOFA),hypertension,diabetes,and the use of vasopressors after correction of all covariates.Results Logistic regression analysis showed that SBP-ARV,a continuous variable,was independently associated with the occurrence of AKI[OR(95%CI):1.05(1.01～1.10),P=0.024].However,DBP-ARV was not significantly related to the occurrence of AKI.When SBP-ARV was grouped by quartile division,Q4 group had a significantly higher risk of AKI[OR(95%CI):1.83(1.04～3.22),P=0.037]compared with that of Q1 group.Analyses across the subgroups revealed that there was an interaction between SBP-ARV and diabetes(P=0.033).Conclusion For ICU patients with hypovolemic shock,SBP-ARV positively associates with the occurrence of AKI.
