Abstract: Objective: To explore the association between intra⁃abdominal hypertension (IAH) at admission and acute kidney injury (AKI) in patients with acute pancreatitis (AP). Methodology: A retrospective analysis was conducted on AP patients admitted to the Department of Critical Care Medicine of Jinling Hospital from January 2017 to October 2021. Demographic characteristics, severity grades, and laboratory measurements at admission were compared between AKI and non⁃AKI patients. One⁃way analysis of variance was used to explore the impact of intra⁃abdominal pressure (IAP) on clinical course; ordered logistic regression evaluated the influence of IAP on AKI classification; logistic regression screened factors influencing AKI; ROC curve analyzed the predictive value of IAP for AKI. Results: A total of 312 patients were included, with 128 (41.0%) having AKI. Compared with non⁃AKI patients, the first IAP measurement at admission was significantly higher in AKI patients (P<0.001). Multivariate logistic analysis showed that IAH at admission significantly increased the risk of AKI (OR=1.153, 95%CI:1.017-1.308, P=0.026). ROC curve analysis showed an AUC of 0.723 (95%CI:0.666-0.781, P<0.001) for IAP predicting AKI; when IAP>12.3 mmHg, sensitivity and specificity were 62.5% and 72.8%. Conclusion: IAP level at admission is independently associated with the occurrence of AKI in AP patients.

Key words: acute pancreatitis, acute kidney injury, intra?abdominal pressure