TY - JOUR
T1 - Reducing mortality in acute kidney injury patients
T2 - Systematic review and international web-based surveY
AU - Landoni, Giovanni
AU - Bove, Tiziana
AU - Székely, Andrea
AU - Comis, Marco
AU - Rodseth, Reitze N.
AU - Pasero, Daniela
AU - Ponschab, Martin
AU - Mucchetti, Marta
AU - Azzolini, Maria L.
AU - Caramelli, Fabio
AU - Paternoster, Gianluca
AU - Pala, Giovanni
AU - Cabrini, Luca
AU - Amitrano, Daniele
AU - Borghi, Giovanni
AU - Capasso, Antonella
AU - Cariello, Claudia
AU - Carpanese, Anna
AU - Feltracco, Paolo
AU - Gottin, Leonardo
AU - Lobreglio, Rosetta
AU - Mattioli, Lorenzo
AU - Monaco, Fabrizio
AU - Morgese, Francesco
AU - Musu, Mario
AU - Pasin, Laura
AU - Pisano, Antonio
AU - Roasio, Agostino
AU - Russo, Gianluca
AU - Slaviero, Giorgio
AU - Villari, Nicola
AU - Vittorio, Annalisa
AU - Zucchetti, Mariachiara
AU - Guarracino, Fabio
AU - Morelli, Andrea
AU - De Santis, Vincenzo
AU - Del Sarto, Paolo A.
AU - Corcione, Antonio
AU - Ranieri, Marco
AU - Finco, Gabriele
AU - Zangrillo, Alberto
AU - Bellomo, Rinaldo
PY - 2013/1/1
Y1 - 2013/1/1
N2 - 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.
AB - 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.
KW - acute kidney failure
KW - acute renal injury
KW - anesthesia
KW - consensus
KW - consensus conference
KW - critical care
KW - mortality
KW - renal failure
KW - survival
KW - web vote
UR - https://www.scopus.com/pages/publications/84888288975
U2 - 10.1053/j.jvca.2013.06.028
DO - 10.1053/j.jvca.2013.06.028
M3 - Review Article
C2 - 24103711
AN - SCOPUS:84888288975
SN - 1053-0770
VL - 27
SP - 1384
EP - 1398
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 6
ER -
