Cargando…
Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis
Background: Acute kidney injury (AKI) is a well-established complication of extra-corporal membrane oxygenation (ECMO) in the adult population. The data in the pediatric and neonatal population is still limited. Moreover, the mortality risk of AKI among pediatric patients requiring ECMO remains uncl...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963279/ https://www.ncbi.nlm.nih.gov/pubmed/31683968 http://dx.doi.org/10.3390/medicines6040109 |
_version_ | 1783488244580614144 |
---|---|
author | Hansrivijit, Panupong Lertjitbanjong, Ploypin Thongprayoon, Charat Cheungpasitporn, Wisit Aeddula, Narothama Reddy Salim, Sohail Abdul Chewcharat, Api Watthanasuntorn, Kanramon Srivali, Narat Mao, Michael A. Ungprasert, Patompong Wijarnpreecha, Karn Kaewput, Wisit Bathini, Tarun |
author_facet | Hansrivijit, Panupong Lertjitbanjong, Ploypin Thongprayoon, Charat Cheungpasitporn, Wisit Aeddula, Narothama Reddy Salim, Sohail Abdul Chewcharat, Api Watthanasuntorn, Kanramon Srivali, Narat Mao, Michael A. Ungprasert, Patompong Wijarnpreecha, Karn Kaewput, Wisit Bathini, Tarun |
author_sort | Hansrivijit, Panupong |
collection | PubMed |
description | Background: Acute kidney injury (AKI) is a well-established complication of extra-corporal membrane oxygenation (ECMO) in the adult population. The data in the pediatric and neonatal population is still limited. Moreover, the mortality risk of AKI among pediatric patients requiring ECMO remains unclear. Thus, this meta-analysis aims to assess the incidence of AKI, AKI requiring renal replacement therapy and AKI associated mortality in pediatric/neonatal patients requiring ECMO. Methods: A literature search was performed utilizing MEDLINE, EMBASE, and the Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring renal replacement therapy (RRT) and the risk of mortality among pediatric patients on ECMO with AKI. Random-effects meta-analysis was used to calculate the pooled incidence of AKI and the odds ratios (OR) for mortality. Results: 13 studies with 3523 pediatric patients on ECMO were identified. Pooled incidence of AKI and AKI requiring RRT were 61.9% (95% confidence interval (CI): 39.0–80.4%) and 40.9% (95%CI: 31.2–51.4%), respectively. A meta-analysis limited to studies with standard AKI definitions showed a pooled estimated AKI incidence of 69.2% (95%CI: 59.7–77.3%). Compared with patients without AKI, those with AKI and AKI requiring RRT while on ECMO were associated with increased hospital mortality ORs of 1.70 (95% CI, 1.38–2.10) and 3.64 (95% CI: 2.02–6.55), respectively. Conclusions: The estimated incidence of AKI and severe AKI requiring RRT in pediatric patients receiving ECMO are high at 61.9% and 40.9%, respectively. AKI among pediatric patients on ECMO is significantly associated with reduced patient survival. |
format | Online Article Text |
id | pubmed-6963279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69632792020-02-26 Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis Hansrivijit, Panupong Lertjitbanjong, Ploypin Thongprayoon, Charat Cheungpasitporn, Wisit Aeddula, Narothama Reddy Salim, Sohail Abdul Chewcharat, Api Watthanasuntorn, Kanramon Srivali, Narat Mao, Michael A. Ungprasert, Patompong Wijarnpreecha, Karn Kaewput, Wisit Bathini, Tarun Medicines (Basel) Article Background: Acute kidney injury (AKI) is a well-established complication of extra-corporal membrane oxygenation (ECMO) in the adult population. The data in the pediatric and neonatal population is still limited. Moreover, the mortality risk of AKI among pediatric patients requiring ECMO remains unclear. Thus, this meta-analysis aims to assess the incidence of AKI, AKI requiring renal replacement therapy and AKI associated mortality in pediatric/neonatal patients requiring ECMO. Methods: A literature search was performed utilizing MEDLINE, EMBASE, and the Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring renal replacement therapy (RRT) and the risk of mortality among pediatric patients on ECMO with AKI. Random-effects meta-analysis was used to calculate the pooled incidence of AKI and the odds ratios (OR) for mortality. Results: 13 studies with 3523 pediatric patients on ECMO were identified. Pooled incidence of AKI and AKI requiring RRT were 61.9% (95% confidence interval (CI): 39.0–80.4%) and 40.9% (95%CI: 31.2–51.4%), respectively. A meta-analysis limited to studies with standard AKI definitions showed a pooled estimated AKI incidence of 69.2% (95%CI: 59.7–77.3%). Compared with patients without AKI, those with AKI and AKI requiring RRT while on ECMO were associated with increased hospital mortality ORs of 1.70 (95% CI, 1.38–2.10) and 3.64 (95% CI: 2.02–6.55), respectively. Conclusions: The estimated incidence of AKI and severe AKI requiring RRT in pediatric patients receiving ECMO are high at 61.9% and 40.9%, respectively. AKI among pediatric patients on ECMO is significantly associated with reduced patient survival. MDPI 2019-11-01 /pmc/articles/PMC6963279/ /pubmed/31683968 http://dx.doi.org/10.3390/medicines6040109 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hansrivijit, Panupong Lertjitbanjong, Ploypin Thongprayoon, Charat Cheungpasitporn, Wisit Aeddula, Narothama Reddy Salim, Sohail Abdul Chewcharat, Api Watthanasuntorn, Kanramon Srivali, Narat Mao, Michael A. Ungprasert, Patompong Wijarnpreecha, Karn Kaewput, Wisit Bathini, Tarun Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title | Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title_full | Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title_fullStr | Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title_full_unstemmed | Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title_short | Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis |
title_sort | acute kidney injury in pediatric patients on extracorporeal membrane oxygenation: a systematic review and meta-analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963279/ https://www.ncbi.nlm.nih.gov/pubmed/31683968 http://dx.doi.org/10.3390/medicines6040109 |
work_keys_str_mv | AT hansrivijitpanupong acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT lertjitbanjongploypin acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT thongprayooncharat acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT cheungpasitpornwisit acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT aeddulanarothamareddy acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT salimsohailabdul acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT chewcharatapi acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT watthanasuntornkanramon acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT srivalinarat acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT maomichaela acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT ungprasertpatompong acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT wijarnpreechakarn acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT kaewputwisit acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis AT bathinitarun acutekidneyinjuryinpediatricpatientsonextracorporealmembraneoxygenationasystematicreviewandmetaanalysis |