Menoufia Medical Journal

REVIEW ARTICLE
Year
: 2019  |  Volume : 32  |  Issue : 4  |  Page : 1163--1168

Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis


Osama A El-Sharqawy1, Khaled M Gaballah1, Mohamed SM Elshahat2 
1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Anesthesia and Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Mohamed SM Elshahat
El Gomhyrea Street Mansoura City, Dakahlia 11711
Egypt

Objectives The aim of the present review is to synthesize evidence from the published literature about the effect of early versus late initiation of renal replacement therapy (RRT) on the outcomes of patients with acute kidney injury (AKI). Backgrounds AKI is a serious clinical disorder with significant increase in risk of mortality and morbidity, especially among hospitalized patients. Data sources A computer literature search of Medline via PubMed, Cochrane CENTRAL Register of Controlled Trials, SCOPUS, and Web of science was conducted. Study selection Records were screened for eligible studies according to the predetermined inclusion and exclusion criteria. Data extraction Data were extracted and synthesized using standardized tables. Data synthesis Dichotomous data were pooled as relative risk (RR) in a random-effect model using Mantel–Haenszel method. Continuous data were pooled as standardized mean difference (SMD) in generic-variance model. We used Review Manager 5.3 for Windows. Findings The present review included nine studies. Our pooled effect estimates did not favor early initiation of RRT versus late intuition in terms of all-causes mortality (RR = 0.88; 95% confidence interval (CI), 0.68, 1.14; P = 0.33), RRT dependence (RR = 0.81; 95% CI, 0.46, 1.42; P = 0.46), length of stay in ICU (SMD, −0.28; 95% CI, −0.58, 0.03; P = 0.08), and length of stay in hospital (SMD, −0.40; 95% CI, −0.83, 0.03; P = 0.07). Conclusion The present systematic review and meta-analysis shows that early initiation of RRT does not improve survival outcomes and hospital stay among patients with AKI, in comparison with late initiation of RRT.


How to cite this article:
El-Sharqawy OA, Gaballah KM, Elshahat MS. Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis.Menoufia Med J 2019;32:1163-1168


How to cite this URL:
El-Sharqawy OA, Gaballah KM, Elshahat MS. Earlier start versus standard start dialysis in patients with acute kidney injury: systematic review and meta-analysis. Menoufia Med J [serial online] 2019 [cited 2020 Feb 22 ];32:1163-1168
Available from: http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2019;volume=32;issue=4;spage=1163;epage=1168;aulast=El-Sharqawy;type=0