Systematic Review and Meta-Analysis of Preventative Strategies for Acute Kidney Injury in Patients Undergoing Abdominal Aortic Aneurysm Repair

医学 荟萃分析 急性肾损伤 腹主动脉瘤 安慰剂 外科 随机对照试验 动脉瘤 内科学 科克伦图书馆 病理 替代医学
作者
Michaela Fernandes,Melissa Majoni,Amit X. Garg,Luc Dubois
出处
期刊:Annals of Vascular Surgery [Elsevier BV]
卷期号:74: 419-430 被引量:7
标识
DOI:10.1016/j.avsg.2020.12.061
摘要

To assess the effect of various preventative interventions for reducing the incidence of postoperative acute kidney injury (AKI) in patients undergoing elective abdominal aortic aneurysm (AAA) repair.We included randomized controlled trials of 10 patients or more which tested a preventative intervention versus standard therapy or placebo in patients undergoing elective AAA repair using the open or endovascular approach. Studies including mixed patient populations such as those with aortic occlusive disease, thoracoabdominal aneurysms or ruptured aneurysms were ineligible for review. We searched Medline (1966-2019), EMBASE (1947-2019), CINAHL (1961-2019), Web of Science (1945-2019), Scopus (1966-2019), and The Cochrane Library (1996-2019) for trials available as published manuscripts in English. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Where possible we pooled the results of similar interventions using random effects meta-analysis.We included 17 trials involving 1443 participants. Most trials were small, single-center studies, with varying definitions of AKI and a high or moderate risk of bias. The preventative strategies with possible protective effects were mannitol, a composite of antioxidant supplements, an open extraperitoneal approach, and human atrial natriuretic peptide (hANP). Curcumin, methylprednisolone, carbon dioxide contrast medium, hemodynamic monitoring and N-acetylcysteine were found to be ineffective. Six trials with a total of 355 participants reported on remote ischemic preconditioning (RIPC) and our meta-analysis showed no statistically significant difference between RIPC and standard treatment (OR 1.20, 95% CI 0.37, 3.89); although the results should be interpreted with caution due to considerable statistical heterogeneity (I2 = 70%). None of the interventions studied significantly reduced receipt of renal replacement therapy (RRT).Interventions that have shown some potential to reduce AKI after AAA repair include mannitol, a composite of antioxidant supplements, an open extraperitoneal approach and hANP. These conclusions are limited by the small size, high risk of bias and inconsistency of the included trials. Large, high quality, multi-center randomized trials will help determine which interventions are effective in reducing the incidence of postoperative AKI among patients undergoing elective AAA repair.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
澡雪发布了新的文献求助10
1秒前
wanci应助123采纳,获得10
2秒前
JILIGULU完成签到,获得积分10
2秒前
jindui发布了新的文献求助10
5秒前
我爱学习发布了新的文献求助10
6秒前
8秒前
李三阳发布了新的文献求助10
8秒前
hj990806完成签到,获得积分10
10秒前
11秒前
123mmmm发布了新的文献求助10
13秒前
17秒前
Orange应助徐婷采纳,获得10
17秒前
冷静如柏完成签到,获得积分10
18秒前
20秒前
今后应助linli采纳,获得10
21秒前
22秒前
今后应助111采纳,获得10
22秒前
ding应助欣慰的乌冬面采纳,获得10
22秒前
ceci完成签到,获得积分10
24秒前
123完成签到,获得积分10
24秒前
今后应助我爱学习采纳,获得10
25秒前
lei029发布了新的文献求助10
25秒前
徐婷完成签到,获得积分10
25秒前
Versa完成签到,获得积分10
27秒前
jindui完成签到,获得积分10
27秒前
28秒前
29秒前
在水一方应助泡泡糖采纳,获得10
29秒前
annie完成签到,获得积分10
30秒前
今后应助科研通管家采纳,获得10
31秒前
yar应助科研通管家采纳,获得10
31秒前
yar应助科研通管家采纳,获得10
31秒前
共享精神应助科研通管家采纳,获得10
31秒前
yar应助科研通管家采纳,获得10
31秒前
所所应助科研通管家采纳,获得10
31秒前
小马甲应助科研通管家采纳,获得10
31秒前
小蘑菇应助科研通管家采纳,获得10
32秒前
李爱国应助科研通管家采纳,获得10
32秒前
yar应助科研通管家采纳,获得10
32秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3975426
求助须知:如何正确求助?哪些是违规求助? 3519848
关于积分的说明 11199831
捐赠科研通 3256122
什么是DOI,文献DOI怎么找? 1798124
邀请新用户注册赠送积分活动 877386
科研通“疑难数据库(出版商)”最低求助积分说明 806305