Department of Nephrology, Nanjing Lishui People's Hospital, Nanjing, Jiangsu, China.
Department of Nephrology, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, Jiangsu, China.
Semin Dial. 2020 Mar;33(2):127-132. doi: 10.1111/sdi.12861. Epub 2020 Mar 9.
Previous investigations showed inconsistent results for comparison in renal recovery, in-hospital, and in-intensive care unit (ICU) mortalities between acute kidney injury (AKI) patients treated with continuous renal replacement therapy (CRRT) and some kinds of intermittent renal replacement therapies (IRRTs). We systematically searched for articles published in the databases (PubMed, Web of Science, EMBASE, Medline, and Google Scholar) until June 2019. We made all statistical analysis using STATA 12.0 software. In the present meta-analysis, relative risks with 95% confidence intervals were calculated for binary outcomes (renal recovery status or mortality). The present study indicated no significant differences in renal recovery, in-hospital mortality, and in-ICU mortality between AKI patients given CRRT and those given sustained low-efficiency dialysis (SLED). Additionally, the study showed no significant difference in in-hospital mortality between AKI patients given CRRT and those given intermittent hemodialysis (IHD), whereas elevated in-ICU mortality was detected in AKI patients given CRRT, compared to those given IHD. The three modalities (CRRT, IHD, and SLED) have their own advantages and disadvantages. More rigorous trials design with large cohort should be made to explore the differences in renal recovery, in-hospital, and in-ICU mortalities between different kinds of RRTs.
先前的研究在比较接受连续性肾脏替代治疗(CRRT)和某些间歇性肾脏替代治疗(IRRT)的急性肾损伤(AKI)患者的肾脏恢复、住院和重症监护病房(ICU)死亡率方面得出了不一致的结果。我们系统地检索了 2019 年 6 月前在数据库(PubMed、Web of Science、EMBASE、Medline 和 Google Scholar)中发表的文章。我们使用 STATA 12.0 软件进行了所有的统计分析。在本荟萃分析中,采用 95%置信区间的相对风险来计算二项结局(肾脏恢复状态或死亡率)。本研究表明,接受 CRRT 和持续低效透析(SLED)的 AKI 患者之间在肾脏恢复、住院死亡率和 ICU 死亡率方面没有显著差异。此外,本研究表明,接受 CRRT 和间歇性血液透析(IHD)的 AKI 患者之间在住院死亡率方面没有显著差异,而接受 CRRT 的 AKI 患者的 ICU 死亡率升高,与接受 IHD 的患者相比。这三种模式(CRRT、IHD 和 SLED)各有优缺点。应进行更严格的试验设计和大样本队列研究,以探讨不同 RRT 之间在肾脏恢复、住院和 ICU 死亡率方面的差异。