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墨西哥急性肾损伤的患病率;对疫情前报告的系统评价和荟萃分析

Prevalence of acute kidney injury in Mexico; a systematic review and meta-analysis of pre-pandemic reports.

作者信息

Zaragoza Jose J, Chavez-Iñiguez Jonathan S, Vazquez-Rangel Armando

机构信息

Critical Care Department, Hospital H + Queretaro, Qro., Mexico, Queretaro, Mexico.

Nephrology Department, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal, Mexico.

出版信息

Ren Fail. 2025 Dec;47(1):2449573. doi: 10.1080/0886022X.2024.2449573. Epub 2025 Jan 30.

Abstract

BACKGROUND

Acute Kidney Injury (AKI) is a health problem worldwide, accounting for high hospital morbidity and mortality. There is little available information regarding the characteristics and incidence of AKI in Latin America (LA), especially in Mexico.

OBJECTIVES

Systematically search the literature and perform a meta-analysis of the epidemiology of AKI in Mexico, to provide data on AKI and kidney replacement therapy (KRT) that would contribute to general knowledge in this matter.

METHODS

We performed a systematic search for articles in pediatric and adult patients admitted to the general ward, Emergency Room or Intensive Care Unit published between January 1, 2000, and September 30, 2024. MEDLINE LILIACS, EMBASE and SciELO were searched, as additional reports from supplements, abstracts, and conference sessions. We performed a random-effects meta-analysis for clinically and methodologically comparable studies to estimate the frequency of AKI and KRT. We calculated pooled estimates stratified by age group, year of publication, and setting.

RESULTS

83 full-text articles were included. The percentage of AKI was calculated at 35% (95% CI, 28-42). Mortality for AKI adult patients was 36% (95% CI, 28-45). An overall KRT rate was 7% (95% CI, 6-9), all-cause mortality for AKI requiring KRT was 49% (95% CI, 42-56), with a global Ι2 estimated in 99.87% ( < 0.01).

CONCLUSION

AKI is common in Mexico and remains a main public health problem that needs to be addressed at every level of care. Efforts should be made to reinitiate AKI research and control in Mexico and LA.

摘要

背景

急性肾损伤(AKI)是一个全球性的健康问题,在医院中发病率和死亡率都很高。关于拉丁美洲(LA),尤其是墨西哥AKI的特征和发病率,现有信息很少。

目的

系统检索文献并对墨西哥AKI的流行病学进行荟萃分析,以提供有关AKI和肾脏替代治疗(KRT)的数据,这将有助于增进对此问题的一般认识。

方法

我们系统检索了2000年1月1日至2024年9月30日期间发表的关于普通病房、急诊室或重症监护病房收治的儿科和成年患者的文章。检索了MEDLINE、LILIACS、EMBASE和SciELO,并补充检索了增刊、摘要和会议报告中的其他报道。我们对临床和方法学上具有可比性的研究进行随机效应荟萃分析,以估计AKI和KRT的发生率。我们按年龄组、发表年份和研究背景计算合并估计值。

结果

纳入83篇全文文章。AKI的发生率计算为35%(95%CI,28 - 42)。成年AKI患者的死亡率为36%(95%CI,28 - 45)。总体KRT率为7%(95%CI,6 - 9),需要KRT的AKI患者的全因死亡率为49%(95%CI,42 - 56),全局I²估计为99.87%(<0.01)。

结论

AKI在墨西哥很常见,仍然是一个需要在各级医疗保健中解决的主要公共卫生问题。应努力在墨西哥和拉丁美洲重新开展AKI的研究和控制工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9982/11784032/1003d23821c6/IRNF_A_2449573_F0001_C.jpg

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