Intensity of continuous renal replacement therapy for acute kidney injury.

摘要: Background Acute kidney injury (AKI) is a common condition among patients in intensive care units (ICU), and associated with substantial morbidity mortality. Continuous renal replacement therapy (CRRT) blood purification technique used to treat the most severe forms of AKI but its effectiveness remains unclear. Objectives To assess effects different intensities (intensive less intensive) CRRT on mortality recovery function critically ill patients. Search methods We searched Cochrane Kidney Transplant's Specialised Register 9 February 2016 through contact Information Specialist using search terms relevant this review. Studies contained are identified strategies specifically designed for CENTRAL, MEDLINE, EMBASE; handsearching conference proceedings; searching International Clinical Trials (ICTRP) Search Portal ClinicalTrials.gov. We also LILACS 2016. Selection criteria We included all randomised controlled trials (RCTs). ICU regardless age, comparing (usually prescribed dose ≥35 mL/kg/h) versus < 35 mL/kg/h). For safety cost outcomes we planned include cohort studies non-RCTs. Data collection analysis Data were extracted independently by two authors. The random-effects model was results reported as risk ratios (RR) dichotomous mean differences (MD) continuous outcomes, 95% confidence intervals (CI). Main results We six enrolling 3185 participants. assessed being at low or unclear bias. There no significant difference between day 30 (5 studies, 2402 participants: RR 0.88, CI 0.71 1.08; I2 = 75%; quality evidence) after days post randomisation 2759 0.92, 0.80 1.06; 65%; evidence). numbers who free RRT discontinuation 1.12, 0.91 1.37; 71%; survivors 1415 1.03, 0.96 1.11; 69%; 90 (3 988 0.98, IC 0.94 1.01, 0%; moderatequality number hospital (2 1665 participants): MD -0.23 days, -3.35 2.89; 8%; -0.58 -3.73 2.56, 19%; Intensive increased hypophosphataemia (1 study, 1441 1.21, 1.11 1.31; high compared CRRT. experienced adverse events 1753 1.08, 0.73 1.61; 16%; moderate In subgroups analysis severity illness aetiology AKI, would seem reduce 531 0.73, 0.61 0.88; only subgroup post-surgical AKI. Authors' conclusions Based current evidence identified, more did not demonstrate beneficial AKI. an intense reduced