Global Risk Factors of Contrast-Induced Acute Kidney Injury: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yong Liu ◽  
Shiqun Chen ◽  
Edmund Y. M. Chung ◽  
Li Lei ◽  
Yibo He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Global Risk

scholarly journals Rates, predictors and mortality of sepsis-associated acute kidney injury: systematic review and meta-analysis

2020 ◽  
Author(s):  
Jie feng Liu ◽  
Hebin Xie ◽  
ziwei ye ◽  
Lesan Wang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Predisposing Factors ◽  
Cochrane Library ◽  
Patient Specific ◽  
Cumulative Number

Abstract Objective:The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result: Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion: A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

Global risk factors of contrast-induced acute kidney injury: systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Liu ◽  
Y Liu ◽  
S Chen ◽  
E.Y.M Chung ◽  
L Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Public Institution ◽  
Left Ventricular Ejection ◽  
Modifiable Risk Factors ◽  
Funding Source

Abstract Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China

Prevalence of acute kidney injury after cardiac surgery:A systematic review and meta-analysis on risk factors and different diagnostic criterias(AKIN,RIFLE,KDIGO)

2019 ◽  
Author(s):  
Alii Alidadii ◽  
Morteza Salarzaei ◽  
Fatem Parooe
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Meta Analysis ◽  
Kidney Injury ◽  
World Health ◽  
Cochrane Library ◽  
Common Symptom ◽  
Total Prevalence

Abstract Objective: This systematic review and meta-analysis aimed to determine the incidence and some of risk factors of AKI after cardiac surgery using all three diagnostic criteria (AKIN,RIFLE, and KIDGO).Method: We searched for published literature in the English language in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID) , KoreaMed and LILACS, and we searched OpenGrey (www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (who.int/ictrp) for unpublished literature and ongoing studies.To ensure the literature saturation, the list of the included research references or the relevant reviews found by searching was studied(MS). The keywords used in the search strategy were Acute kidney injury,acute renal failure, creatinine,cardiac surgery,heart surgury, Coronary artery bypass grafting(CABG),valve replacement,RIFLE (risk, injury, failure, loss, end-stage renal disease) ,Acute Kidney Injury Network (AKIN),KDIGO (Kidney Disease: Improving Global Outcomes) , which were combined using the AND, OR, and NOT operators.Results: A total of 33298 patients who had undergone the cardiac surgery were studied. Based on the random effect model the total prevalence of AKI in 33298 patients undergone the heart surgery was 26.3% (95% confidence interval[CI]:26.1%,26.6%, I2=99.5%). the total prevalence of AKI in patients undergone cardiac surgery based on AKIN criteria was 21.6% (95% CI –21.2%, 22.1%,I2=98.5%) of whom 21.6% (95% CI-21.2%,22.1%,I2=98.5%) were classified as AKIN stage 1, whereas 3% (95% CI-2.7%%,3.4%%,I2=90.6%) were classified as AKIN stage 2, and 3.2% (95% CI-3.0%%,3.4%%,I2=97.2%) were classified as AKIN stage 3. the total prevalence of AKI in patients undergone cardiac surgery based on RIFLE criteria was 26.0%% (95% CI –25.6%, 26.5%,I2=99.4%). total prevalence of AKI in patients undergone cardiac surgery based on KDIGO criteria was 34.7% (95% CI –33.8%, 35.7%,I2=98.4%). the highest prevalence of AKI in patients undergone cardiac surgery was in Brazil 45.7% (95% CI –43.6%, 47.8%) based on 3 articles included followed by USA with a prevalence of 29.6%(95% CI –28.7%, 29.4%) based on 7 articles included, Uruguay with a prevalence of 36.1%(95% CI –35%, 37.2%) based on 1 article, Canada with a prevalence of 16.7%(95% CI –15.7%, 17.6%) based on 4 articles included and Italy with a prevalence of 10.6%(95% CI –9.8%, 11.3%) based on 3 articles included.Conclusion: AKI after cardiac surgery is a common symptom, although most often more severe in elderly patients. The prevalence of AKI after cardiac surgery based on KDIGO criteria was found to be higher than RIFLE and AKIN. The prevalence of AKI regardless of the definition used showed a decreasing trend from 2009 to 2019. Our findings pointed to the superiority of the KDIGO criterion over RIFLE and AKIN for diagnosing and evaluating AKI after cardiac surgery. However, the widespread acceptance of consensus definitions ( RIFLE and AKIN criteria) for AKI is still reflected in the studies. In order to progress further, establishment of a uniform definition for AKI seems necessary.

scholarly journals Modifiable risk factors of acute kidney injury after liver transplantation: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jian Zhou ◽  
Xueying Zhang ◽  
Lin Lyu ◽  
Xiaojun Ma ◽  
Guishen Miao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Protective Factor ◽  
Calcineurin Inhibitor ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Kidney Injury ◽  
Modifiable Risk Factors

Abstract Background Acute kidney injury (AKI) is a common and critical complication of liver transplantation (LT), which is associated with increased morbidity, mortality and health care cost. We aimed to identify modifiable risk factors of AKI after LT. Methods A literature search of Pubmed, EMBASE and Cochrane Databases was performed to identify studies investigating risk factors of AKI after LT. The Newcastle-Ottawa Scale was used to rate study quality. Effect size and 95% confidence interval were pooled using a random-effect model with inverse-variance method. Results Sixty-seven articles with 28,844 patients were included in the meta-analysis. Seventeen modifiable risk factors were found, including overweight, preoperative use of diuretic, preoperative anemia, donation after cardiac death organ, donor BMI ≥ 30 kg/m2, ABO-incompatible LT, low graft to recipient body weight ratio, intraoperative hypotension, major bleeding, intraoperative use of vasopressor, large RBC transfusion, postreperfusion syndrome, postoperative use of vasopressors, overexposure to calcineurin inhibitor, calcineurin inhibitor without mycophenolate mofetil, graft dysfunction and infection. A total of 38 articles were included in the systematic review, in which 8 modifiable risk factors and 1 protective factor were additionally associated in single studies with the incidence of AKI after LT. Conclusions Effective interventions based on identified modifiable risk factors in the perioperative management and graft allocation and preservation may be promising to reduce the incidence of AKI after LT. Trial registration The protocol for this systematic review is registered with PROSPERO (No. CRD42020166918).

scholarly journals Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qian Hu ◽  
Shao-Jun Li ◽  
Qian-Ling Chen ◽  
Han Chen ◽  
Qiu Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Apgar Score ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Increased Risk ◽  
Critically Ill Neonates

Background and Objective: Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention.Methods: The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Studies published from the initiation of the database to November 19, 2020, were included. The quality of studies was assessed by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist. The meta-analysis was conducted with Stata 15 and drafted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.Results: Seventeen studies (five cohort studies, ten case-control studies, and two cross-sectional studies) were included in meta-analysis, with 1,627 cases in the case group and 5,220 cases in the control group. The incidence of AKI fluctuated from 8.4 to 63.3%. Fifteen risk factors were included, nine of which were significantly associated with an increased risk of AKI in critically ill neonates: gestational age [standardized mean difference (SMD) = −0.31, 95%CI = (−0.51, −0.12), P = 0.002], birthweight [SMD = −0.37, 95%CI = (−0.67, −0.07), P = 0.015], 1-min Apgar score [SMD = −0.61, 95%CI = (−0.78, −0.43), P = 0.000], 5-min Apgar score [SMD = −0.71, 95%CI = (−1.00, −0.41), P = 0.000], congenital heart disease (CHD) [odds ratio (OR) = 2.94, 95%CI = (2.08, 4.15), P = 0.000], hyperbilirubinemia [OR = 2.26, 95%CI = (1.40, 3.65), P = 0.001], necrotizing enterocolitis (NEC) [OR = 6.32, 95%CI = (2.98, 13.42), P = 0.000], sepsis [OR = 2.21, 95%CI = (1.25, 3.89), P = 0.006], and mechanical ventilation [OR = 2.37, 95%CI = (1.50, 3.75), P = 0.000]. Six of them were not significantly associated with AKI in critically ill neonates: age [SMD = −0.25, 95%CI = (−0.54, 0.04), P = 0.095], male sex [OR = 1.10, 95%CI =(0.97, 1.24), P = 0.147], prematurity [OR = 0.90, 95%CI(0.52, 1.56), P = 0.716], cesarean section [OR = 1.52, 95%CI(0.77, 3.01), P = 0.234], prenatal hemorrhage [OR = 1.41, 95%CI = (0.86, 2.33), P = 0.171], and vancomycin [OR = 1.16, 95%CI = (0.71, 1.89), P = 0.555].Conclusions: This meta-analysis provides a preliminary exploration of risk factors in critically ill neonatal AKI, which may be useful for the prediction of AKI.Systematic Review Registration: PROSPERO (CRD42020188032).

scholarly journals Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis

2020 ◽  
Author(s):  
Jie feng Liu ◽  
Hebin Xie ◽  
ziwei ye ◽  
Lesan Wang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Predisposing Factors ◽  
Cochrane Library ◽  
Patient Specific ◽  
Cumulative Number

Abstract Objective The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

scholarly journals Acute kidney injury and kidney replacement therapy in COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 13 (4) ◽  
pp. 550-563 ◽  
Author(s):  
Edouard L Fu ◽  
Roemer J Janse ◽  
Ype de Jong ◽  
Vera H W van der Endt ◽  
Jet Milders ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Replacement Therapy ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Original Data ◽  
Increased Risk ◽  
Kidney Replacement Therapy ◽  
Meta Regression

Abstract Background Acute kidney injury (AKI) can affect hospitalized patients with coronavirus disease 2019 (COVID-19), with estimates ranging between 0.5% and 40%. We performed a systematic review and meta-analysis of studies reporting incidence, mortality and risk factors for AKI in hospitalized COVID-19 patients. Methods We systematically searched 11 electronic databases until 29 May 2020 for studies in English reporting original data on AKI and kidney replacement therapy (KRT) in hospitalized COVID-19 patients. Incidences of AKI and KRT and risk ratios for mortality associated with AKI were pooled using generalized linear mixed and random-effects models. Potential risk factors for AKI were assessed using meta-regression. Incidences were stratified by geographic location and disease severity. Results A total of 3042 articles were identified, of which 142 studies were included, with 49 048 hospitalized COVID-19 patients including 5152 AKI events. The risk of bias of included studies was generally low. The pooled incidence of AKI was 28.6% [95% confidence interval (CI) 19.8–39.5] among hospitalized COVID-19 patients from the USA and Europe (20 studies) and 5.5% (95% CI 4.1–7.4) among patients from China (62 studies), whereas the pooled incidence of KRT was 7.7% (95% CI 5.1–11.4; 18 studies) and 2.2% (95% CI 1.5–3.3; 52 studies), respectively. Among patients admitted to the intensive care unit, the incidence of KRT was 20.6% (95% CI 15.7–26.7; 38 studies). Meta-regression analyses showed that age, male sex, cardiovascular disease, diabetes mellitus, hypertension and chronic kidney disease were associated with the occurrence of AKI; in itself, AKI was associated with an increased risk of mortality, with a pooled risk ratio of 4.6 (95% CI 3.3–6.5). Conclusions AKI and KRT are common events in hospitalized COVID-19 patients, with estimates varying across geographic locations. Additional studies are needed to better understand the underlying mechanisms and optimal treatment of AKI in these patients.

scholarly journals Risk factors for contrast-induced acute kidney injury (CI-AKI): protocol for systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030048 ◽  
Author(s):  
Yong Liu ◽  
Xingcheng Liang ◽  
Shaojun Xin ◽  
Jin Liu ◽  
Guoli Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Individual Risk ◽  
Targeted Prevention ◽  
Modifiable Factors ◽  
Registration Number ◽  
Newcastle Ottawa Scale

IntroductionIdentifying the patients who are at risk for contrast-induced acute kidney injury (CI-AKI), which is defined as an increase in serum creatinine after exposure to contrast media, is a critical step in targeted prevention strategies. The absolute and relative importance of individual risk factors have not been systematically evaluated, let alone the new, controversial and modifiable risk factors of CI-AKI.Methods and analysisOn 1 July 2019, a search was performed on MEDLINE, Embase and the Cochrane Database of Systematic Reviews. We will perform a systematic review and meta-analysis to assess the important risk factors for developing CI-AKI, including those new, modifiable factors, which are considered controversial. The secondary endpoint will be all-cause mortality. Two authors will then independently screen studies that meet the criteria for inclusion, consulting with a third author to resolve any dispute. The quality of the included studies will be assessed according to the Newcastle-Ottawa scale.Ethics and disseminationEthics approval in this systematic review and meta-analysis protocol is not needed. We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.PROSPERO registration numberCRD42019121534

scholarly journals Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis

2020 ◽  
Author(s):  
Jie feng Liu ◽  
Hebin Xie ◽  
ziwei ye ◽  
Fen Li ◽  
Lesan Wang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Predisposing Factors ◽  
Cochrane Library ◽  
Patient Specific ◽  
Wide Range

Abstract Background: Due to the high incidence and mortality of sepsis-associated acute kidney injury, a significant number of studies have explored the causes of sepsis-associated acute kidney injury (AKI). However, the opinions on relevant predictive risk factors remain inconclusive. This study aimed to provide a systematic review and a meta-analysis to determine the predisposing factors for sepsis-associated AKI.Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed, and Web of Science, databases, with an end-date of 25th May 2019. Valid data were retrieved in compliance with specific inclusion and exclusion criteria.Result: Forty-seven observational studies were included for analysis, achieving a cumulative patient number of 55,911. The highest incidence of AKI was caused by septic shock. Thirty-one potential risk factors were included in the meta-analysis. Analysis showed that 20 factors were statistically significant. The odds ratio (OR) and 95% confidence interval (CI), as well as the prevalence of the most frequently-seen predisposing factors for sepsis-associated AKI, were as follows: septic shock [2.88 (2.36-3.52), 60.47%], hypertension [1.43 (1.20-1.70), 38.39%], diabetes mellitus [1.59 (1.47-1.71), 27.57%], abdominal infection [1.44 (1.32-1.58), 30.87%], the administration of vasopressors [2.95 (1.67-5.22), 64.61%], the administration of vasoactive drugs [3.85 (1.89-7.87), 63.22%], mechanical ventilation [1.64 (1.24-2.16), 68.00%], positive results from blood culture [1.60 (1.35-1.89), 41.19%], and a history of smoking [1.60 (1.09-2.36), 43.09%]. Other risk factors included cardiovascular diseases, coronary artery diseases, liver diseases, unknown infections, the administration of diuretics and ACEI/ARB, infection caused by gram-negative bacteria, and organ transplantation.Conclusion: Risk factors of S-AKI arise from a wide range of sources, making it difficult to predict and prevent this condition. Comorbidities, and certain drugs, are the main risk factors for S-AKI. Our review can provide guidance on the application of interventions to reduce the risks associated with sepsis-associated acute kidney injury and can also be used to tailor patient-specific treatment plans and management strategies in clinical practice.

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