ArticleJournal of anesthesia, analgesia and critical care2026
Acute kidney injury is a major mediator of intra-abdominal pressure-related mortality in critically ill patients: a longitudinal analysis.
Article in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIntra-abdominal hypertension (IAH) is a common complication in critically ill patients and is associated with increased mortality. While acute kidney injury (AKI) and respiratory impairment are also linked to IAH, their roles as mediators of mortality remain unclear. This study aimed to evaluate the associations between IAH and mortality, with a focus on AKI and pulmonary parameters as potential mediators.
methodsThis retrospective cohort study utilized the MIMIC-IV database and included adult patients admitted to the intensive care unit (ICU) with intra-abdominal pressure measurements. Patients with previous advanced kidney disease or early kidney replacement therapy (KRT) were excluded. Time-varying exposure to IAH, AKI status, and respiratory parameters were analyzed via marginal structural models (MSMs) and a mediational g-formula to assess the effects of mediation on mortality.
resultsAmong the 555 patients, IAH was associated with mortality HR 2.20 (95% CI 1.54-2.56) and stage 3 AKI emerged as a significant mediator of IAH-associated mortality, accounting for almost half (41.5%, p < 0.001) of the excess mortality. KRT was associated with a protective effect, reducing the hazard ratio for mortality by 16.6%. Although the need for mechanical ventilation per se mediated a statistically significant but small effect of IAH on mortality (4.2%), no respiratory parameters, including driving pressure, demonstrated a significant mediating role.
conclusionSevere acute kidney injury (stage 3) is a key mediator of IAH-related mortality in critically ill patients, whereas KRT was associated with a protective effect. The absence of an important mediating role for respiratory parameters suggests that the relationship between IAH and mortality is driven primarily by renal mechanisms. However, pulmonary impairment may not have been fully captured by the variables studied, particularly in a retrospective study. Unmeasured aspects of pulmonary dysfunction could still contribute to mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.