Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2019  |  Volume : 32  |  Issue : 4  |  Page : 1163-1168

Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis

1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Anesthesia and Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Mohamed SM Elshahat
El Gomhyrea Street Mansoura City, Dakahlia 11711
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_184_18

Rights and Permissions

Objectives The aim of the present review is to synthesize evidence from the published literature about the effect of early versus late initiation of renal replacement therapy (RRT) on the outcomes of patients with acute kidney injury (AKI). Backgrounds AKI is a serious clinical disorder with significant increase in risk of mortality and morbidity, especially among hospitalized patients. Data sources A computer literature search of Medline via PubMed, Cochrane CENTRAL Register of Controlled Trials, SCOPUS, and Web of science was conducted. Study selection Records were screened for eligible studies according to the predetermined inclusion and exclusion criteria. Data extraction Data were extracted and synthesized using standardized tables. Data synthesis Dichotomous data were pooled as relative risk (RR) in a random-effect model using Mantel–Haenszel method. Continuous data were pooled as standardized mean difference (SMD) in generic-variance model. We used Review Manager 5.3 for Windows. Findings The present review included nine studies. Our pooled effect estimates did not favor early initiation of RRT versus late intuition in terms of all-causes mortality (RR = 0.88; 95% confidence interval (CI), 0.68, 1.14; P = 0.33), RRT dependence (RR = 0.81; 95% CI, 0.46, 1.42; P = 0.46), length of stay in ICU (SMD, −0.28; 95% CI, −0.58, 0.03; P = 0.08), and length of stay in hospital (SMD, −0.40; 95% CI, −0.83, 0.03; P = 0.07). Conclusion The present systematic review and meta-analysis shows that early initiation of RRT does not improve survival outcomes and hospital stay among patients with AKI, in comparison with late initiation of RRT.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded138    
    Comments [Add]    

Recommend this journal