Acute Kidney Injury Following Mannitol Administration in Traumatic Brain Injury: a Meta-analysis

BACKGROUND: Acute kidney injury (AKI) is one of the most frequent but anticipated potential complications. The objective of this meta-analysis was to evaluate the AKI incidence following mannitol administration in traumatic brain injury (TBI) patients worldwide. OBJECTIVE: So in this study, authors will discuss the incidence of AKI related to the provision of mannitol in TBI cases so it is expected to provide a better prevention of complications. METHODS: We were using meta-analysis. Studies were searched throughout Pubmed, Cochrane, JNS in December 2017. Studies that were included ranged from 2009-2018. Keywords were “renal” or “kidney” and “traumatic brain injury”. Inclusion criteria were full-text observational study or randomized control trial, subjects in study were newly diagnosed AKI after TBI, GCS < 13, with age range 15-100 years old, survived and followed at least for 30 days after discharge, and given mannitol at least 1g/kg BW/day for at least 3 days. From 648 studies, total 4 studies were eligible for this study. Statistical analysis was done by using Review Manager 5. RESULTS: From those 4 studies, it is shown than the pooled risk ratio AKI incidence following mannitol administration in traumatic brain injury (TBI) was 1.57. The pooled risk ratio had wide heterogeneity (I(2) = 0.95 and 1, p< 0.05) so random effect model was used. CONCLUSION: AKI appeared more frequent in patient with TBI with mannitol administration. It still needs more multicentre and long term period researches in the future to get better understanding AKI in TBI following mannitol administration.