OBJECTIVE: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting. DESIGN AND SETTING: Systematic literature review and international web-based survey. PARTICIPANTS: More than 300 physicians from 62 countries. INTERVENTIONS: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality. MEASUREMENTS AND MAIN RESULTS: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically ill patients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically ill patients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions. CONCLUSION: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.
OBJECTIVE: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting. DESIGN AND SETTING: Systematic literature review and international web-based survey. PARTICIPANTS: More than 300 physicians from 62 countries. INTERVENTIONS: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality. MEASUREMENTS AND MAIN RESULTS: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically illpatients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically illpatients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions. CONCLUSION: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.
Authors: Jacob T Gutsche; Hynek Riha; Prakash Pate; Lance Atchley; Elizabeth Valentine; Ronak Shah; Sophia T Cisler; Stuart J Weiss; George Silvay; John G T Augoustides Journal: Heart Lung Vessel Date: 2015
Authors: Amit X Garg; Andrea Kurz; Daniel I Sessler; Meaghan Cuerden; Andrea Robinson; Marko Mrkobrada; Chirag Parikh; Richard Mizera; Philip M Jones; Maria Tiboni; Raul Gonzalez Rodriguez; Ekaterina Popova; Maria Fernanda Rojas Gomez; Christian S Meyhoff; Tomas Vanhelder; Matthew T V Chan; David Torres; Joel Parlow; Miriam de Nadal Clanchet; Mohammed Amir; Seyed Javad Bidgoli; Laura Pasin; Kristian Martinsen; German Malaga; Paul Myles; Rey Acedillo; Pavel Roshanov; Michael Walsh; George Dresser; Priya Kumar; Edith Fleischmann; Juan Carlos Villar; Tom Painter; Bruce Biccard; Sergio Bergese; Sadeesh Srinathan; Juan P Cata; Vincent Chan; Bhupendra Mehra; Kate Leslie; Richard Whitlock; P J Devereaux Journal: BMJ Open Date: 2014-02-25 Impact factor: 2.692
Authors: Yabing Zhang; Xiyang Zhang; Dongmei Chi; Siyang Wang; Hua Wei; Hong Yu; Qian Li; Bin Liu Journal: Medicine (Baltimore) Date: 2016-09 Impact factor: 1.889