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Báo cáo y học: "Endothelial A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury: a systematic review and meta-analysis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Endothelial A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury: a systematic review and meta-analysis. | Karvellas et al. Critical Care 2011 15 R72 http ccforum.eom content 15 1 R72 KS CRITICAL CARE RESEARCH Open Access A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury a systematic review and meta-analysis nnci 2ni ino I kArx ollsỉc 1 D rhsỉi 2 Itnron QtỉíítỉH3 Qitn nn c ỉ l ì iQncQn4 A Icivunrlcir A I OI mm5 Dn n A tỉIH6 coi isidi nil ie J Kaiveiids MdHd R rdiiidt Iiiiidii Sdjjdd Jimun S Mogensen Alexdnder A Leung Ron Vvdld Sean M Bdgshdw1 Abstract Introduction Our dim wds to investigdte the impdct of edrly versus idte initidtion of rendl repldcement therdpy RRT on clinicdl outcomes in criticdlly ill pdtients with dcute kidney injury AKI . Methods Systemdtic review dnd metd-dndlysis were used in this study. PUBMED EMBASE SCOPUS Web of Science dnd Cochrdne Central Registry of Controlled Clinicdl Tridls dnd other sources were sedrched in July 2010. Eligible studies selected were cohort dnd randomised tridls thdt dssessed timing of initidtion of RRT in criticdlly ill ddults with AKI. Results We identified 15 unique studies 2 randomised 4 prospective cohort 9 retrospective cohort out of 1 494 citdtions. The overall methodologicdl qudlity wds low. Edrly compdred with ldte therapy wds dssocidted with d significdnt improvement in 28-ddy mortdlity odds ratio OR 0.45 95 confidence intervdl CI 0.28 to 0.72 . There wds significdnt heterogeneity dmong the 15 pooled studies I2 78 . In subgroup dndlyses stratifying by pdtient populdtion surgicdl n 8 vs. mixed n 7 or study design prospective n 10 vs. retrospective n 5 there wds no impdct on the overall summdry estimdte for mortdlity. Metd-regression controlling for illness severity Acute Physiology And Chronic Hedlth Evdludtion II APACHE II bdseline credtinine dnd ured did not impdct the overall summdry estimdte for mortdlity. Of studies reporting seconddry outcomes five studies out of seven reported gredter rendl recovery seven out of eight studies showed