Christchurch Kidney Research Group, Department of Medicine, University of Otago, Christchurch, New Zealand.
Pediatr Nephrol. 2013 Feb;28(2):207-17. doi: 10.1007/s00467-012-2171-3. Epub 2012 May 26.
Apart from supportive dialysis there are no universally accepted interventions in acute kidney injury (AKI). We have summarized the outcomes of all published randomized, placebo-controlled studies of non-dialysis treatment of AKI. Forty-nine trials were identified, only one of which was in a paediatric population. Sixteen trials had positive outcomes; these trials are not comparable in terms of methodology used or outcomes assessed, and they share many of the problems of the negative trials. We discuss the flaws in clinical trial design that have contributed to poor or uncertain outcomes and propose minimum requirements for future trials. In particular, future trials should incorporate biomarkers specific to the etiology of the AKI, and treatment should match the phase of injury.
除了支持性透析外，急性肾损伤（AKI）目前并没有被普遍认可的干预措施。我们总结了所有已发表的非透析治疗 AKI 的随机、安慰剂对照研究的结果。共确定了 49 项试验，其中只有 1 项是儿科人群。16 项试验有阳性结果；这些试验在所用方法或评估结果方面无法进行比较，而且它们与阴性试验有许多共同的问题。我们讨论了导致不良或不确定结果的临床试验设计缺陷，并为未来的试验提出了最低要求。特别是，未来的试验应该纳入与 AKI 病因特异性的生物标志物，且治疗应与损伤阶段相匹配。
