Nephrology
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Review Meta Analysis
Acute Kidney Injury and mortality prognosis in Acute Coronary Syndrome patients: A meta-analysis.
The aim of this study is to provide a robust estimate of mortality risk in acute coronary syndrome (ACS)-associated acute kidney injury (AKI) to inform clinical practice and policy. ⋯ Acute coronary syndrome-associated AKI is associated with more than a three-fold increase in early mortality and more than two-fold in long-term mortality.
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Review Meta Analysis
Prognostic value of cell cycle arrest biomarkers in patients at high risk for acute kidney injury: A systematic review and meta-analysis.
Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are G1 cell cycle arrest biomarkers. This systematic review aimed to evaluate the prognostic value of urinary [TIMP-2]·[IGFBP7] in patients at high risk for AKI. The MEDLINE (via PubMed), Ovid, EMBASE and Cochrane Library databases were systematically searched from inception to December 25, 2016. ⋯ Urinary [TIMP-2]·[IGFBP7] for mortality prediction in patients at high risk for AKI was assessed by qualitative description. Based on the above data, urinary [TIMP-2]·[IGFBP7] performs well in predicting the need for RRT and mortality in patients at high risk for AKI. However, further meta-analyses are warranted as more data become available.
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Review Meta Analysis
Initiation time of renal replacement therapy on patients with acute kidney injury: A systematic review and meta-analysis of 8179 participants.
The early initiation of renal replacement therapy has been recommended for patients with acute renal failure by some studies, but its effects on mortality and renal recovery are unknown. We conducted an updated meta-analysis to provide quantitative evaluations of the association between the early initiation of renal replacement therapy and mortality for patients with acute kidney injury. After applying inclusion/exclusion criteria, 51 studies, including 10 randomized controlled trials, with a total of 8179 patients were analyzed. ⋯ The early initiation of renal replacement therapy was associated with a decreased risk of all-cause mortality compared with the late initiation of RRT in patients with acute kidney injury. These findings should be interpreted with caution given the heterogeneity between studies. Further studies are needed to identify the causes of mortality and to assess whether mortality differs by dialysis dose.
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Review Meta Analysis
Effect of preoperative statin therapy on postoperative acute kidney injury in patients undergoing major surgery: systemic review and meta-analysis.
We aimed to examine the association between preoperative use of statins and postoperative acute kidney injury (AKI) in patients undergoing major surgery by performing a systemic review and meta-analysis. MEDLINE and EMBASE, from inception to April 2013, and the reference lists of related articles were searched for relevant studies. Trials comparing preoperative statin therapy with no preoperative statin in patients undergoing major surgery were included. ⋯ In patients undergoing major surgery, preoperative statin therapy could associate with a reduced risk for postoperative AKI. However, considerable heterogeneity existed among included studies. Future randomized trials were warranted for this critical clinical question.
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Meta Analysis
Relationship of cystatin-C change and the prevalence of death or dialysis need after acute kidney injury: a meta-analysis.
Cystatin-C (CysC) has been demonstrated as a sensitive and reliable biomarker to predict the onset of acute kidney injury (AKI). However, there are few studies concerned about the relationship between CysC and the outcomes of AKI. The aim of the present study was to determine whether CysC elevation prior to definite diagnosis of AKI is related to higher prevalence of death and dialysis need outcome. ⋯ Patients with CysC elevated prior to AKI diagnosis have higher risk to develop death and need dialysis during short- and long-term follow-up after AKI, thus having worse outcomes. This population deserves more careful observation and might benefit from more frequent follow-up visits in the clinic. Future work is needed to get a consensus cut-off value defining CysC elevation.