Ma Haiying, Liu Hengjian, Liu Yi, Wang Yi, He Jiang, Yang Qiaoyun
Department of Critical Care Medicine, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, China.
Department of Critical Care Medicine, Changzhou No. 2 People's Hospital, Changzhou, Jiangsu, China.
Evid Based Complement Alternat Med. 2023 Apr 17;2023:8688974. doi: 10.1155/2023/8688974. eCollection 2023.
This study aimed to compare the clinical efficacy of continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) in patients with renal failure in intensive care unit (ICU).
Relevant studies were searched in the databases including EMBASE, Cochrane Library, and MEDLINE (PubMed) from inception to January 04, 2021. The inclusion of available studies and the collection of data were independently conducted by two authors after reviewing the full text. Pooled analyses of relative risk (RR) and weighted mean difference (WMD) were performed to compare the outcomes of renal recovery, short-term mortality, length of ICU stays, and length of in-hospital stays between the two different treatment groups. Publication bias was assessed by the funnel plot.
A total of 11 RCT studies including 1740 patients with renal failure were eligible for final analysis. Among them, 894 patients (51.4%) underwent CRRT and 846 patients (48.6%) received IHD. Pooled analysis did not find significant differences in renal recovery and short-term mortality between the two groups. Interestingly, patients underwent CRRT showed significantly shorter length of ICU stay and in-hospital stay than those who underwent IHD (ICU stay: RR: -0.61, 95%CI: -1.10--0.11, < 0.05; I = 93.6%; in-hospital stay: RR: -0.56, 95%CI: -1.41-0.28, < 0.05; I = 97.7%). No significant publication biases were observed on the funnel plots.
Compared with IHD, CRRT had similar effects on renal recovery and short-term mortality in patients with renal failure in ICU. As a promising technique in clinical practice, CRRT could significantly reduce the length of ICU stay and in-hospital stay of patients, which was of great significance for the reduction of medical costs and the long-term benefits of patients, thereby reducing the burden on society and individuals.
本研究旨在比较连续性肾脏替代治疗（CRRT）和间歇性血液透析（IHD）在重症监护病房（ICU）肾衰竭患者中的临床疗效。
在包括EMBASE、Cochrane图书馆和MEDLINE（PubMed）在内的数据库中检索从创刊至2021年1月4日的相关研究。两名作者在审阅全文后独立进行纳入可用研究和数据收集。进行相对危险度（RR）和加权均数差（WMD）的合并分析，以比较两种不同治疗组之间肾脏恢复、短期死亡率、ICU住院时间和住院时间的结果。通过漏斗图评估发表偏倚。
共有11项随机对照试验研究，包括1740例肾衰竭患者符合最终分析条件。其中，894例患者（51.4%）接受了CRRT，846例患者（48.6%）接受了IHD。合并分析未发现两组之间在肾脏恢复和短期死亡率方面有显著差异。有趣的是，接受CRRT的患者的ICU住院时间和住院时间明显短于接受IHD的患者（ICU住院时间：RR：-0.61，95%CI：-1.10--0.11，<0.05；I=93.6%；住院时间：RR：-0.56，95%CI：-1.41-0.28，<0.05；I=97.7%）。在漏斗图上未观察到显著的发表偏倚。
与IHD相比，CRRT对ICU中肾衰竭患者的肾脏恢复和短期死亡率有相似的效果。作为临床实践中有前景的技术，CRRT可显著缩短患者的ICU住院时间和住院时间，这对于降低医疗成本和患者的长期益处具有重要意义，从而减轻社会和个人的负担。
