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
Osama A El-Sharqawy1, Khaled M Gaballah1, Mohamed SM Elshahat2
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
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).
AKI is a serious clinical disorder with significant increase in risk of mortality and morbidity, especially among hospitalized patients.
A computer literature search of Medline via PubMed, Cochrane CENTRAL Register of Controlled Trials, SCOPUS, and Web of science was conducted.
Records were screened for eligible studies according to the predetermined inclusion and exclusion criteria.
Data were extracted and synthesized using standardized tables.
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.
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).
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.
Mohamed SM Elshahat
El Gomhyrea Street Mansoura City, Dakahlia 11711
|How to cite this article:|
El-Sharqawy OA, Gaballah KM, Elshahat MS. Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis.Menoufia Med J 2019;32:1163-1168
|How to cite this URL:|
El-Sharqawy OA, Gaballah KM, Elshahat MS. Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis. Menoufia Med J [serial online] 2019 [cited 2020 Apr 2 ];32:1163-1168
Available from: http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2019;volume=32;issue=4;spage=1163;epage=1168;aulast=El-Sharqawy;type=0