Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis

Abstract

Previous investigations showed inconsistent results for comparison in renal recovery, in‐hospital, and in‐intensive care unit (ICU) mortalities between acute kidney injury (AKI) patients treated with continuous renal replacement therapy (CRRT) and some kinds of intermittent renal replacement therapies (IRRTs). We systematically searched for articles published in the databases (PubMed, Web of Science, EMBASE, Medline, and Google Scholar) until June 2019. We made all statistical analysis using STATA 12.0 software. In the present meta‐analysis, relative risks with 95% confidence intervals were calculated for binary outcomes (renal recovery status or mortality). The present study indicated no significant differences in renal recovery, in‐hospital mortality, and in‐ICU mortality between AKI patients given CRRT and those given sustained low‐efficiency dialysis (SLED). Additionally, the study showed no significant difference in in‐hospital mortality between AKI patients given CRRT and those given intermittent hemodialysis (IHD), whereas elevated in‐ICU mortality was detected in AKI patients given CRRT, compared to those given IHD. The three modalities (CRRT, IHD, and SLED) have their own advantages and disadvantages. More rigorous trials design with large cohort should be made to explore the differences in renal recovery, in‐hospital, and in‐ICU mortalities between different kinds of RRTs.

Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis

“…With the exception of one small-sized study of 70 participants [21], most studies included in this review involved about 200 critically ill patients and had high mortality rates of more than 50%. A recent meta-analysis reported that AKI patients who received CRRT had a 21% higher in-ICU mortality than patients with intermittent hemodialysis [48]. Despite this, very few studies have examined the relationship between CRRT and in-hospital mortality.…”

Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

“…Pajewski and colleagues supported the findings that a higher proportion of patients on CKRT had a better chance of kidney recovery (71.4% vs. 31.4%) in comparison to IHD [70]. On the other hand, other studies failed to show a significant difference in AKI outcome among different dialysis modalities on kidney recovery [23,80,[82][83][84][85][86][87].…”

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

“…Our updated literature search identified no new RCTs but two meta-analysis comparing continuous and intermittent renal replacement therapies [ 503 , 504 ]. The quality of evidence was judged as low.…”