Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
BMJ Open. 2020 Sep 15;10(9):e038725. doi: 10.1136/bmjopen-2020-038725.
People with chronic kidney disease receiving dialysis (CKD G5D) have an increased risk of poor postoperative outcomes and a high incidence of major surgery. Despite the high burden of these combined risks, there is a paucity of evidence to support tailored perioperative strategies to manage this population. A comprehensive evidence synthesis would inform the management of these patients in the perioperative period and identify knowledge gaps. We describe a protocol for a scoping review of the literature to identify existing perioperative strategies, protocols, pathways and interventions for people with CKD G5D undergoing major surgery.
We will conduct a scoping review in accordance with the Joanna Briggs Institute methodology and report per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. In February 2020, we will complete our search of MEDLINE, EMBASE, CINAHL Plus, Cochrane Database of Systematic Reviews, and Cochrane Controlled Trials Registry for published literature from inception to present. All study types are eligible for inclusion, without language restriction. Studies reporting a perioperative intervention in adult patients with CKD G5D are eligible for inclusion. Studies in prevalent kidney transplant patients or patients with acute kidney injury, and studies that report on surgical approaches without consideration of perioperative management strategies, will be excluded. Reviewers will independently assess abstracts for all identified studies in duplicate, and again at the full-text stage. Following published literature searches, a search of the grey literature will be developed. We will extract and narratively report study, participant and intervention details. This will include a summary table outlining the strategies employed, organised into post hoc developed perioperative domains.
Ethical considerations do not apply to this scoping review. Findings will be disseminated through relevant conference presentations and publications.
接受透析治疗的慢性肾脏病 5 期（CKD G5D）患者术后结局较差的风险增加，且需要进行大型手术的概率较高。尽管这些合并风险负担沉重，但缺乏支持针对该人群制定围手术期策略的证据。全面的证据综合将为管理这些患者的围手术期提供信息，并确定知识空白。我们描述了一项文献范围综述的方案，以确定接受大型手术的 CKD G5D 患者现有的围手术期策略、方案、途径和干预措施。
我们将根据 Joanna Briggs 研究所的方法进行范围综述，并按照系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）报告。2020 年 2 月，我们将完成对 MEDLINE、EMBASE、CINAHL Plus、Cochrane 系统评价数据库和 Cochrane 对照试验登记处的文献搜索，涵盖从成立到现在的已发表文献。所有研究类型均符合纳入标准，无语言限制。符合纳入标准的研究包括报告 CKD G5D 成年患者围手术期干预措施的研究。不包括现患肾移植患者或急性肾损伤患者的研究，以及仅报告手术方法而不考虑围手术期管理策略的研究。审查员将独立地对所有确定的研究进行重复的摘要评估，并在全文阶段再次进行评估。在进行了已发表文献搜索之后，将制定灰色文献的搜索。我们将提取和叙述性地报告研究、参与者和干预措施的详细信息。这将包括一个概述所采用策略的总结表，按照事后制定的围手术期领域进行组织。
这项范围综述不需要考虑伦理问题。研究结果将通过相关会议报告和出版物进行传播。
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