ArticleBMC nephrology2017
Low mean perfusion pressure is a risk factor for progression of acute kidney injury in critically ill patients - A retrospective analysis.
Article in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07481097 (Hemodynamic Resuscitation Guided by Non-Invasive Mean Systemic Filling Pressure to Prevent Acute Kidney Injury in Septic Shock), which is not on this map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hemodynamic Resuscitation Guided by Non-Invasive Mean Systemic Filling Pressure to Prevent Acute Kidney Injury in Septic Shock: A Randomized Controlled Trial Integrating Renal Doppler Indices
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Pooled it
- Elevated central venous pressure is associated with increased mortality and acute kidney injury in critically ill patients: a meta-analysis.Critical care (London, England) · 2020Pooled it
- Mean airway pressure as an independent risk factor for developing acute kidney injury in mechanically ventilated critically ill patients: a multi-center retrospective analysis.Renal failure · 2026Article
- A Pathophysiological Approach for Early Detection and Prevention of AKI in the NICU.American journal of perinatology · 2026Review
- Critical care considerations in rhabdomyolysis-associated acute kidney injury and kidney replacement therapy.World journal of nephrology · 2026Review
- VExUS versus CVP for assessing venous congestion: oasis or mirage?Critical care (London, England) · 2026Article
- Association between haemodynamics during cardiopulmonary resuscitation and cerebral arterial enhancement.Resuscitation plus · 2026Article
- Renal congestion syndrome in critically ill patients: a neglected mechanism of acute kidney injury - A narrative review.Annals of intensive care · 2026Review
- Biomarker-driven risk stratification and early intervention in acute kidney injury: a comprehensive review from early warning to clinical response.Frontiers in medicine · 2026Review
- Applied physiology at the bedside: using invasive blood pressure as a true monitoring tool.Annals of intensive care · 2025Review
- Association between renal mean perfusion pressure and prognosis in patients with sepsis-associated acute kidney injury: insights from the MIMIC IV database.Renal failure · 2025Article
- PEEP-AKI-COVID ICU: Effect of positive end-expiratory pressure on acute kidney injury development in patients with COVID-19-associated acute respiratory distress syndrome: an ancillary analysis of the COVID-ICU study.Journal of intensive care · 2025Article
- Review
- Renal perfusion pressure: role and implications in critical illness.Annals of intensive care · 2025Review
- Renal Doppler ultrasound to predict acute kidney injury in critically ill patients with acute circulatory failure.Journal of clinical monitoring and computing · 2025Observational
- Central venous pressure: current uses and prospects for an old parameter.Intensive care medicine · 2025Article
- Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation.Journal of personalized medicine · 2025Review
- Non-linear associations between renal perfusion pressure indexes and AKI incidence and recovery rate.European journal of medical research · 2025Article
- The Association Between Central Venous Pressure and Acute Kidney Injury Development in Patients with Septic Shock.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients.
methodsRetrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I. We compared patients with a MPP above and below the median value in the first 12 h of diagnosis of AKI. Multivariable logistic regression analyses were performed to identify independent risk factors for progression to AKI III, to explore the impact of MAP and CVP separately, and to investigate the impact of MPP in pre-defined sub-groups.
resultsAmong 2118 ICU patients, 790 patients (37%) developed AKI I of whom 205 underwent advanced haemodynamic monitoring within 12 h of AKI stage I. Their median MPP was 59 mmHg. AKI I patients with a MPP ≤59 mmHg had a significantly higher risk of progressing to AKI stage III (48.6% versus 34%, respectively; p = 0.0034). This association was stronger in patients with ischemic heart disease, congestive cardiac failure or without pre-existing hypertension and in patients with a MAP <65 mmHg for >1 h. As individual components, a raised CVP was independently associated with progression to AKI stage III but MAP alone was not an independent risk factor for AKI progression.
conclusionMPP <60 mmHg was independently associated with AKI progression. CVP was the key component of MPP.
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