Blood pressure and acute kidney injury

Crit Care. 2017 Feb 10;21(1):28. doi: 10.1186/s13054-017-1611-7.

Abstract

Maintaining the optimal blood pressure is an important aspect of preventing acute kidney injury (AKI), especially for vasopressor-dependent patients. Although mean arterial pressure (MAP) has played an important role in previous trials for prevention of AKI, there is little evidence that MAP actually reflects organ perfusion. In fact, several studies have suggested that perfusion pressure, including diastolic perfusion pressure and mean perfusion pressure (MPP) and calculated with central venous pressure (CVP), may be more useful than the widely used MAP to help prevent AKI. This emphasizes the importance of maintaining diastolic arterial pressure and avoiding elevation of CVP to prevent AKI in patients with sepsis or invasive surgery. To achieve this, further investigation regarding titrated fluid therapy and vasopressors is warranted.

Keywords: Acute kidney injury; Central venous pressure; Diastolic perfusion pressure; Mean arterial pressure; Mean perfusion pressure.

Publication types

  • Letter

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / physiopathology*
  • Arterial Pressure / physiology
  • Blood Pressure / physiology*
  • Central Venous Pressure / physiology
  • Fluid Therapy / methods
  • Humans
  • Vasoconstrictor Agents / pharmacology
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents