Original InvestigationPathogenesis and Treatment of Kidney DiseaseAcute Kidney Injury and Prognosis After Cardiopulmonary Bypass: A Meta-analysis of Cohort Studies
Section snippets
Study Protocol
This systematic review and meta-analysis was conducted using a prespecified protocol and according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).6
Search Strategy and Selection Criteria
We searched MEDLINE and EMBASE without language restriction for January 1, 2004, to June 2, 2014, using the following medical subject heading (MeSH) terms: acute kidney injury, renal failure, renal replacement therapy, dialysis, cardiac surgical procedure, cardiopulmonary bypass, coronary artery bypass, mortality,
Description of Included Studies and Participants
The systematic search identified 3,618 citations, of which 320 were retrieved for full-text examination after review by title and abstract. Overall, 46 studies reporting on 47 cohorts comprising 242,388 patients (Fig 1; Table 1) were eligible and included in the review. Sample size varied from 68 to 28,220 (median, 1,610) participants (Table 1). There were 45 cohorts adjusted for covariates reporting at least one of early or late mortality outcomes. Data were extractable for the association
Discussion
This meta-analysis including 242,000 patients at risk of AKI after CPB highlights the prognostic importance of AKI. Adults experiencing CPB-associated AKI experienced markedly increased premature mortality following surgery. Importantly, differing consortia- or guideline-based definitions for AKI provided similar prognostic information about CPB-associated AKI for early death in this clinical setting. Markedly increased risks of death with CPB-associated AKI persisted even when inconsistencies
Acknowledgements
We thank the multiple authors who responded to our requests for additional information.
Support: None.
Financial Disclosure: Dr Pickering has undertaken consultancy for AMPharma. The other authors declare that they have no relevant financial interests.
Contributions: Research idea and study design: JWP, SCP, MJ; data acquisition: JWP; data analysis/interpretation: JWP, SCP, MJ; statistical analysis: JWP. Each author contributed important intellectual content during manuscript drafting or revision
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