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

The patients undergoing kidney transplantation are exposed to Intra-Abdominal Pressure (IAP) elevation following a surgery. 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. This longitudinal study was conducted on 135 kidney transplant patients in two hospitals in Iran/Afghanistan from February 2019 to the end of October 2019. The patients' IAP was measured by nurses every 6 h up to 24 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 14. Out of 135 patients, an increase in IAP>10 mmHg was observed in 9.5% of cases. Urinary loss and creatinine decrease more than 25% of baseline indicated a significant correlation with IAP mean difference (P=0.001) (4-1). Therefore, IAP could predict renal dysfunction based on the reduction of urinary volume and a decrease in creatinine of more than 25% of baseline. Finally, a comparison between the diagnostic power of the IAP measurement method and Doppler ultrasound indicated 90% of sensitivity and 94% 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.