Early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients: A systematic review and meta-analysis
Autoři:
Li Xiao aff001; Lu Jia aff002; Rongshan Li aff002; Yu Zhang aff003; Hongming Ji aff002; Andrew Faramand aff004
Působiště autorů:
Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China,Chengdu, Sichuan, China
aff001; Shanxi Provincial People’s Hospital, Taiyuan, China
aff002; Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
aff003; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
aff004
Vyšlo v časopise:
PLoS ONE 14(10)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0223493
Souhrn
Background
Acute kidney injury is associated with high mortality, and is the most frequent complication encountered in patients residing in the intensive care unit. Although renal replacement therapy (RRT) is the standard of care for acute kidney injury, the optimal timing for initiation is still unknown.
Methods
We conducted a systemic review and meta-analysis of randomized controlled trials evaluating early versus late initiation of RRT in critically ill patients with acute kidney injury. We searched MEDLINE, Embase, and CENTRAL databases from inception to October 15, 2018. We screened studies and extracted data from published reported independently. The primary outcome was short-term mortality.
Results
A total of 2242 patients were included from 11 trials. No statistically significant effect was found for early versus late initiation of RRT on short-term mortality (risk ratio [RR] 0.99, 95% CI 0.84–1.17, p = 0.93) or long-term mortality (RR 0.98, 95% CI 0.85–1.13, p = 0.76). There were also no statistically significant effects on ICU length of stay, hospital length of stay, recovery of renal function, and renal replacement therapy dependence. Early initiation of RRT decreased the risk of metabolic acidosis (RR 0.65, 95% CI 0.43–0.99, p = 0.04), but increased the risk of hypotension (RR 1.24, 95% CI 1.08–1.43, p = 0.003).
Conclusions
In critically ill patients with acute kidney injury, early compared with late initiation of RRT is not associated with favorable mortality outcomes, although it appears to reduce the risk of metabolic acidosis.
Klíčová slova:
Death rates – Cardiology – Renal system – Kidneys – Intensive care units – Hypotension – Acidosis
Zdroje
1. Quenot JP, Binquet C, Kara F, Martinet O, Ganster F, Navellou JC, et al. The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study. Crit Care. 2013;17(2):R65. Epub 2013/04/09. doi: 10.1186/cc12598 23561510; PubMed Central PMCID: PMC4056892.
2. Investigators RRTS, Bellomo R, Cass A, Cole L, Finfer S, Gallagher M, et al. Intensity of continuous renal-replacement therapy in critically ill patients. The New England journal of medicine. 2009;361(17):1627–38. Epub 2009/10/23. doi: 10.1056/NEJMoa0902413 19846848.
3. Schiffl H. Choice of renal replacement therapy modality and long-term dialysis dependence. Where do we stand after three decades? Critical care medicine. 2014;42(7):e540–1. Epub 2014/06/17. doi: 10.1097/CCM.0000000000000280 24933070.
4. Schneider AG, Bellomo R, Bagshaw SM, Glassford NJ, Lo S, Jun M, et al. Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis. Intensive care medicine. 2013;39(6):987–97. Epub 2013/02/28. doi: 10.1007/s00134-013-2864-5 23443311.
5. Wald R, Bagshaw SM. The timing of renal replacement therapy initiation in acute kidney injury: is earlier truly better?*. Critical care medicine. 2014;42(8):1933–4. Epub 2014/07/17. doi: 10.1097/CCM.0000000000000432 25029128.
6. Bouman CS, Oudemans-Van Straaten HM, Tijssen JG, Zandstra DF, Kesecioglu J. Effects of early high-volume continuous venovenous hemofiltration on survival and recovery of renal function in intensive care patients with acute renal failure: a prospective, randomized trial. Critical care medicine. 2002;30(10):2205–11. Epub 2002/10/24. doi: 10.1097/00003246-200210000-00005 12394945.
7. Payen D, Mateo J, Cavaillon JM, Fraisse F, Floriot C, Vicaut E, et al. Impact of continuous venovenous hemofiltration on organ failure during the early phase of severe sepsis: a randomized controlled trial. Critical care medicine. 2009;37(3):803–10. Epub 2009/02/25. doi: 10.1097/CCM.0b013e3181962316 19237881.
8. Combes A, Brechot N, Amour J, Cozic N, Lebreton G, Guidon C, et al. Early High-Volume Hemofiltration versus Standard Care for Post-Cardiac Surgery Shock. The HEROICS Study. Am J Respir Crit Care Med. 2015;192(10):1179–90. Epub 2015/07/15. doi: 10.1164/rccm.201503-0516OC 26167637.
9. Gaudry S, Hajage D, Schortgen F, Martin-Lefevre L, Pons B, Boulet E, et al. Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit. The New England journal of medicine. 2016;375(2):122–33. Epub 2016/05/18. doi: 10.1056/NEJMoa1603017 27181456.
10. Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstadt H, et al. Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury: The ELAIN Randomized Clinical Trial. Jama. 2016;315(20):2190–9. Epub 2016/05/23. doi: 10.1001/jama.2016.5828 27209269.
11. Besen B, Romano TG, Mendes PV, Gallo CA, Zampieri FG, Nassar AP Jr., et al. Early Versus Late Initiation of Renal Replacement Therapy in Critically Ill Patients: Systematic Review and Meta-Analysis. Journal of intensive care medicine. 2017:885066617710914. Epub 2017/06/02. doi: 10.1177/0885066617710914 28569129.
12. Lai TS, Shiao CC, Wang JJ, Huang CT, Wu PC, Chueh E, et al. Earlier versus later initiation of renal replacement therapy among critically ill patients with acute kidney injury: a systematic review and meta-analysis of randomized controlled trials. Ann Intensive Care. 2017;7(1):38. Epub 2017/04/07. doi: 10.1186/s13613-017-0265-6 28382597; PubMed Central PMCID: PMC5382114.
13. Luo K, Fu S, Fang W, Xu G. The optimal time of initiation of renal replacement therapy in acute kidney injury: A meta-analysis. Oncotarget. 2017;8(40):68795–808. Epub 2017/10/06. doi: 10.18632/oncotarget.17946 28978157; PubMed Central PMCID: PMC5620297.
14. Yang XM, Tu GW, Zheng JL, Shen B, Ma GG, Hao GW, et al. A comparison of early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials. BMC Nephrol. 2017;18(1):264. Epub 2017/08/09. doi: 10.1186/s12882-017-0667-6 28784106; PubMed Central PMCID: PMC5547509.
15. Feng YM, Yang Y, Han XL, Zhang F, Wan D, Guo R. The effect of early versus late initiation of renal replacement therapy in patients with acute kidney injury: A meta-analysis with trial sequential analysis of randomized controlled trials. PLoS One. 2017;12(3):e0174158. Epub 2017/03/23. doi: 10.1371/journal.pone.0174158 28329026; PubMed Central PMCID: PMC5362192.
16. Barbar SD, Clere-Jehl R, Bourredjem A, Hernu R, Montini F, Bruyere R, et al. Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis. The New England journal of medicine. 2018;379(15):1431–42. Epub 2018/10/12. doi: 10.1056/NEJMoa1803213 30304656.
17. Lumlertgul N, Peerapornratana S, Trakarnvanich T, Pongsittisak W, Surasit K, Chuasuwan A, et al. Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial). Critical Care. 2018;22(1):101. doi: 10.1186/s13054-018-2021-1 29673370
18. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of internal medicine. 2009;151(4):W65–94. Epub 2009/07/23. doi: 10.7326/0003-4819-151-4-200908180-00136 19622512.
19. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ (Clinical research ed). 2008;336(7650):924–6. Epub 2008/04/26. doi: 10.1136/bmj.39489.470347.AD 18436948; PubMed Central PMCID: PMC2335261.
20. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58. Epub 2002/07/12. doi: 10.1002/sim.1186 12111919.
21. Durmaz I, Yagdi T, Calkavur T, Mahmudov R, Apaydin AZ, Posacioglu H, et al. Prophylactic dialysis in patients with renal dysfunction undergoing on-pump coronary artery bypass surgery. The Annals of thoracic surgery. 2003;75(3):859–64. Epub 2003/03/21. doi: 10.1016/s0003-4975(02)04635-0 12645707.
22. Sugahara S, Suzuki H. Early start on continuous hemodialysis therapy improves survival rate in patients with acute renal failure following coronary bypass surgery. Hemodial Int. 2004;8(4):320–5. Epub 2004/10/01. doi: 10.1111/j.1492-7535.2004.80404.x 19379436.
23. Jamale TE, Hase NK, Kulkarni M, Pradeep KJ, Keskar V, Jawale S, et al. Earlier-start versus usual-start dialysis in patients with community-acquired acute kidney injury: a randomized controlled trial. Am J Kidney Dis. 2013;62(6):1116–21. Epub 2013/08/13. doi: 10.1053/j.ajkd.2013.06.012 23932821.
24. Wald R, Adhikari NK, Smith OM, Weir MA, Pope K, Cohen A, et al. Comparison of standard and accelerated initiation of renal replacement therapy in acute kidney injury. Kidney international. 2015;88(4):897–904. Epub 2015/07/15. doi: 10.1038/ki.2015.184 26154928.
25. Wang H, Li L, Chu Q, Wang Y, Li Z, Zhang W, et al. Early initiation of renal replacement treatment in patients with acute kidney injury: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(46):e5434. Epub 2016/11/20. doi: 10.1097/md.0000000000005434 27861388; PubMed Central PMCID: PMC5120945.
26. Pasin L, Boraso S, Tiberio I. Early initiation of renal replacement therapy in critically ill patients: a meta-analysis of randomized clinical trials. BMC Anesthesiol. 2019;19(1):62. Epub 2019/05/02. doi: 10.1186/s12871-019-0733-7 31039744; PubMed Central PMCID: PMC6492439.
27. Jaber S, Paugam C, Futier E, Lefrant JY, Lasocki S, Lescot T, et al. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet (London, England). 2018;392(10141):31–40. Epub 2018/06/19. doi: 10.1016/s0140-6736(18)31080-8 29910040.
28. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179–84. Epub 2012/08/15. doi: 10.1159/000339789 22890468.
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