Renal failure
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Review Meta Analysis Comparative Study
Percutaneous coronary intervention compared with coronary artery bypass graft in coronary artery disease patients with chronic kidney disease: a systematic review and meta-analysis.
Previous reports of percutaneous coronary intervention versus coronary artery bypass graft outcomes in coronary artery disease patients with chronic kidney disease (CKD) were inconsistent. We evaluated the optimal revascularization strategy for CKD patients. We searched Pub Med, EMBASE, and the Cochrane Central Register of Controlled Trials and scanned the references of relevant articles and reviews. ⋯ In subgroup analyses of dialysis patients receiving percutaneous coronary intervention with stents versus coronary artery bypass graft, CKD patients with multivessel coronary disease, and CKD patients receiving drug-eluting stent versus coronary artery bypass graft, the pooled outcomes revealed that percutaneous coronary intervention possessed lower short-term mortality, but higher late revascularization risk. No significant differences in long-term mortality were observed between the two strategies in these subgroup analyses. In conclusion, in some specific clinical circumstances, CKD patients receiving percutaneous coronary intervention possessed lower short-term all-cause mortality, but higher long-term revascularization risk, than coronary artery bypass graft; long-term all-cause mortality was not different between the two strategies.
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Review Meta Analysis
Association of endothelial nitric oxide synthase gene polymorphisms with end-stage renal disease: a systematic review and meta-analysis.
Endothelial nitric oxide synthase (eNOS) is one of the potent regulators of intra renal hemodynamics. Polymorphisms of eNOS gene may be involved in the progression of renal disease, and may be the causative factors that contribute to the deterioration of renal functions. During the past decades, several studies investigated the association of eNOS polymorphisms with the risk of end-stage renal disease (ESRD), but the results remain unclear and the mechanisms are not defined. Our study was designed to examine the role of different eNOS genetic polymorphisms in the progression of ESRD. ⋯ The evidence accumulated suggested that 4b/a and G894T polymorphisms in the eNOS gene were associated with ESRD susceptibility, indicating that 4a and T allele carriers might become significant genetic molecular markers for the onset of ESRD in overall populations. However, more studies should be performed in the further studies.
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The association between statins use and the risk of acute kidney injury (AKI) remains elusive. We aimed to evaluate the association of statins use with AKI risk by performing a meta-analysis. Twenty-one studies were included in our meta-analysis by searching electronic databases according to predefined criteria. ⋯ Exclusion of any single study had little impact on the pooled ORs. In conclusion, statins use is not associated with the risk of AKI in overall populations, Caucasians, Asians, and patients undergoing cardiac and elective surgery. Statins use decreases the risk of CIN and may increase the risk of AKI in CAP patients.
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Review Meta Analysis
Timing of initiation of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis.
The aim of the study is to summarize the effects of timing of initiation of renal replacement therapy (RRT) on mortality. ⋯ "Early" CRRT and "early" IHD both could reduce the mortality of patients with acute kidney injury compared with "late" CRRT or IHD.
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Review Meta Analysis
The dose of continuous renal replacement therapy for acute renal failure: a systematic review and meta-analysis.
To conduct a systematic review of the literature to summarize the best available evidence regarding the mortality and morbidity associated with differing dosing regimens of continuous renal replacement therapy (CRRT) for patients with acute renal failure (ARF) in an intensive care unit setting. ⋯ Increased dosing of CRRT is not associated with a decrease in mortality of patients with ARF in an intensive care unit setting.