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Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis
BACKGROUND: The effects of early continuous renal replacement therapy (CRRT) on mortality in patients with septic acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis was performed to investigate the impact of timing of CRRT on clinical outcomes in patients with sept...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831327/ https://www.ncbi.nlm.nih.gov/pubmed/31415389 http://dx.doi.org/10.1097/MD.0000000000016800 |
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author | Li, Yuting Li, Hongxiang Zhang, Dong |
author_facet | Li, Yuting Li, Hongxiang Zhang, Dong |
author_sort | Li, Yuting |
collection | PubMed |
description | BACKGROUND: The effects of early continuous renal replacement therapy (CRRT) on mortality in patients with septic acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis was performed to investigate the impact of timing of CRRT on clinical outcomes in patients with septic AKI. METHODS: The PubMed, Cochrane, and Embase databases were searched from inception to the 31st of March 2019, to identify trials that assessed the timing of initiation of CRRT in patients with septic AKI. RESULTS: Five trials including 900 patients were included. The results of this meta-analysis showed that there was no significant difference between 28-day mortality (odds ratio = 0.76;95% CI, 0.58–1.00; P = .05) and 90-day mortality(odds ratio = 0.79;95% CI, 0.59–1.06; P = .12)of early and late initiation of CRRT group. In addition, compared with late initiation strategy, early initiation showed no significant advantage in length of stay in ICU (Mean difference = −0.9;95% CI, −2.37 to 0.57; P = .23) and length of stay in hospital (Mean difference = −1.43;95% CI, −5.28 to 2.41; P = .47). CONCLUSION: Our meta-analysis revealed that early initiation of CRRT could not reduce mortality in patients with septic AKI. The study also showed no significant difference in ICU length of stay or hospital length of stay between early and late CRRT group. To achieve optimal timing of CRRT for septic AKI, large multicenter randomized trials with better design are still needed. |
format | Online Article Text |
id | pubmed-6831327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-68313272019-11-19 Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis Li, Yuting Li, Hongxiang Zhang, Dong Medicine (Baltimore) 3900 BACKGROUND: The effects of early continuous renal replacement therapy (CRRT) on mortality in patients with septic acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis was performed to investigate the impact of timing of CRRT on clinical outcomes in patients with septic AKI. METHODS: The PubMed, Cochrane, and Embase databases were searched from inception to the 31st of March 2019, to identify trials that assessed the timing of initiation of CRRT in patients with septic AKI. RESULTS: Five trials including 900 patients were included. The results of this meta-analysis showed that there was no significant difference between 28-day mortality (odds ratio = 0.76;95% CI, 0.58–1.00; P = .05) and 90-day mortality(odds ratio = 0.79;95% CI, 0.59–1.06; P = .12)of early and late initiation of CRRT group. In addition, compared with late initiation strategy, early initiation showed no significant advantage in length of stay in ICU (Mean difference = −0.9;95% CI, −2.37 to 0.57; P = .23) and length of stay in hospital (Mean difference = −1.43;95% CI, −5.28 to 2.41; P = .47). CONCLUSION: Our meta-analysis revealed that early initiation of CRRT could not reduce mortality in patients with septic AKI. The study also showed no significant difference in ICU length of stay or hospital length of stay between early and late CRRT group. To achieve optimal timing of CRRT for septic AKI, large multicenter randomized trials with better design are still needed. Wolters Kluwer Health 2019-08-16 /pmc/articles/PMC6831327/ /pubmed/31415389 http://dx.doi.org/10.1097/MD.0000000000016800 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | 3900 Li, Yuting Li, Hongxiang Zhang, Dong Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title | Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title_full | Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title_fullStr | Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title_full_unstemmed | Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title_short | Timing of continuous renal replacement therapy in patients with septic AKI: A systematic review and meta-analysis |
title_sort | timing of continuous renal replacement therapy in patients with septic aki: a systematic review and meta-analysis |
topic | 3900 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831327/ https://www.ncbi.nlm.nih.gov/pubmed/31415389 http://dx.doi.org/10.1097/MD.0000000000016800 |
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