Presión arterial media como marcador predictor de fallo renal agudo en pacientes mayores de 40 años en la unidad de cuidados intensivos del Hospital Teodoro Maldonado Carbo 2024.

Abstract

Introduction: Mean arterial pressure (MAP) is an indicator of tissue perfusion and is essential for maintaining adequate kidney function. Despite existing evidence linking hypotension with the development of acute kidney injury (ARF), it has not yet been determined whether MAP can be an early marker for identifying patients at risk for AKI. Objective: To determine the predictive capacity of MAP in patients over 40 years of age hospitalized in the Intensive care unit (ICU) of Teodoro Maldonado Carbo Hospital in 2024 for the development of AKI. Methodology: This is an observational, retrospective, cross-sectional study involving patients with AKI in the ICU in 2024, over 40 years of age, whose medical records were reviewed to extract the different variables. Results: A total of 126 ICU patients were diagnosed with AKI in 2024, 61.1% were men, 34.9% women, and the mean age was 66.37 years, where the majority of patients were between 40-75 years old. The patients' clinical presentation showed that 72.2% had a MAP less than 60 mmHg, 94.4% had elevated creatinine, 60.3% had elevated serum urea levels at least 2 times the normal value, and 90.5% had low urine output. This study identified that all variables analyzed were significantly associated with the development of AKI. Specifically, a low MAP (OR = 0.110, p = 0.000) was associated with a lower risk of severe AKI, considering it as a predictor of AKI. While high creatinine levels (OR = 5.585), high urea (OR = 2.600), and low urine output (OR = 4.050) increased the risk, a higher risk was also observed with low DBP (OR = 2.720) and low SBP (OR = 3.320), suggesting renal hypoperfusion. Conclusion: MAP was a clinical predictor of AKI.