Abstract:
Acute kidney injury (AKI) is a frequent complication of cardiac surgery, which can lead to higher mortality and long-term renal function impairment. The effect of perioperative renin-angiotensin system inhibitors (RASi) therapy on AKI incidence in patients undergoing cardiac surgery remains controversial. We reviewed related studies in PubMed, Scopus, and Cochrane Library from inception to February 2020. Two randomized controlled trials and 21 cohort studies were included in the meta-analysis, involving 76,321 participants. The pooled odds ratio and 95% confidence interval were calculated using the DerSimonian and Laird random-effects model. The results showed no significant association between perioperative RASi therapy and postoperative AKI in patients undergoing cardiac surgery. We highlighted the limitations of existing studies and called for well-designed large-scale randomized controlled trials to verify the conclusion.
摘要:
急性肾损伤(AKI)是心脏手术的常见并发症,这可能导致更高的死亡率和长期肾功能损害。围手术期肾素-血管紧张素系统抑制剂(RASi)治疗对心脏手术患者AKI发生率的影响仍存在争议。我们回顾了PubMed的相关研究,Scopus,和Cochrane图书馆从成立到2020年2月。两项随机对照试验和21项队列研究纳入荟萃分析,涉及76,321名参与者。使用DerSimonian和Laird随机效应模型计算合并比值比和95%置信区间。结果显示,心脏手术患者围手术期RASi治疗与术后AKI之间没有显着关联。我们强调了现有研究的局限性,并呼吁精心设计的大规模随机对照试验来验证这一结论。