scholarly journals Hypertension as a Risk Factor for Contrast-Associated Acute Kidney Injury: A Meta-Analysis Including 2,830,338 Patients

2021 ◽  
pp. 1-23
Author(s):  
Zhubin Lun ◽  
Ziling Mai ◽  
Liwei Liu ◽  
Guanzhong Chen ◽  
Huanqiang Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Database ◽  
Number Of Patients ◽  
Increased Risk ◽  
Random Models ◽  
Definition Of ◽  
The Relationship

<b><i>Objective:</i></b> Previous studies have shown that the relationship between hypertension (HT) and contrast-associated acute kidney injury (CA-AKI) is not clear. We apply a systematic review and meta-analysis to assess the association between HT and CA-AKI. <b><i>Methods:</i></b> We searched for articles on the study of risk factors for CA-AKI in the Embase, Medline, and Cochrane Database of Systematic Reviews (by March 25, 2021). Two authors independently performed quality assessment and extracted data such as the studies’ clinical setting, the definition of CA-AKI, and the number of patients. The CA-AKI was defined as a serum creatinine (SCr) increase ≥25% or ≥0.5 mg/dL from baseline within 72 h. We used fixed or random models to pool adjusted OR (aOR) by STATA. <b><i>Results:</i></b> A total of 45 studies (2,830,338 patients) were identified, and the average incidence of CA-AKI was 6.48%. There was an increased risk of CA-AKI associated with HT (aOR: 1.378, 95% CI: 1.211–1.567, <i>I</i><sup>2</sup> = 67.9%). In CA-AKI with a SCr increase ≥50% or ≥0.3 mg/dL from baseline within 72 h, an increased risk of CA-AKI was associated with HT (aOR: 1.414, 95% CI: 1.152–1.736, <i>I</i><sup><i>2</i></sup> = 0%). In CA-AKI with a Scr increase ≥50% or ≥0.3 mg/dL from baseline within 7 days, HT increases the risk of CA-AKI (aOR: 1.317, 95% CI: 1.049–1.654, <i>I</i><sup><i>2</i></sup> = 51.5%). <b><i>Conclusion:</i></b> Our meta-analysis confirmed that HT is an independent risk factor for CA-AKI and can be used to identify risk stratification. Physicians should pay more attention toward prevention and treatment of patients with HT in clinical practice.

scholarly journals Ethnicity-Stratified Analysis of the Association between TNF-α Genetic Polymorphisms and Acute Kidney Injury: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Guanzhong Chen ◽  
Bowen Liu ◽  
Huanqiang Li ◽  
Ziling Mai ◽  
Liyao Zhang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Genetic Polymorphisms ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Asian Population ◽  
Necrosis Factor Alpha ◽  
Increased Risk ◽  
Tnf Α ◽  
Stratified Analysis ◽  
The Relationship

Background. Several studies have reported conflicting findings regarding the association between tumor necrosis factor-alpha (TNF-α) genetic polymorphisms and acute kidney injury (AKI). Therefore, we performed this meta-analysis to further investigate whether TNF-α variants are related to AKI susceptibility. Methods. A comprehensive search of observational studies on the association of TNF-α polymorphism with AKI susceptibility was conducted in the PubMed, Cochrane, and Embase databases through February 10, 2020. Pooled odds ratios (ORs) and 95% corresponding confidence intervals (95% CIs) were analyzed to evaluate the strength of the relationship. Results. A total of 8 studies involving 6694 patients (2559 cases and 4135 controls) were included. Pooled analysis showed a trend of increased risk between the TNF-α rs1800629 variant and AKI (A vs. G: OR   95 % CI = 1.33   0.98 ‐ 1.81 ) among the overall population. Ethnicity-stratified analysis indicated that the TNF-α rs1800629 variant was a risk factor for Asians ( OR   95 % CI = 1.93   1.59 ‐ 2.35 ) while it is not for Caucasians ( OR   95 % CI = 1.04   0.91 ‐ 1.20 ). Additionally, we also found that TNF-α rs1799964 polymorphism was observed to have a significant relationship with AKI risk in Asian patients (C vs. T, OR   95 % CI = 1.26   1.11 ‐ 1.43 ). Conclusions. The TNF rs1800629 polymorphism exhibited a trend toward AKI susceptibility with ethnic differences. The relationship was found to be significant among the Asian population, but not among those of Caucasian origin. Additionally, the TNF-α rs1799964 polymorphism was also related to a significantly increased risk of AKI in Asians.

scholarly journals Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis

2019 ◽  
Vol 8 (3) ◽  
pp. 372 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Kaewput ◽  
Natanong Thamcharoen ◽  
Tarun Bathini ◽  
Kanramon Watthanasuntorn ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Graft Failure ◽  
Meta Analysis ◽  
Random Effect ◽  
Kidney Injury ◽  
Incidence Rates ◽  
Liver Graft ◽  
Inverse Variance ◽  
Increased Risk ◽  
The Individual

Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies assessing the incidence of AKI (using a standard AKI definition) in adult patients undergoing LTx. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, the generic inverse variance approach of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018100664). Results: Thirty-eight cohort studies, with a total of 13,422 LTx patients, were enrolled. Overall, the pooled estimated incidence rates of post-LTx AKI and severe AKI requiring renal replacement therapy (RRT) were 40.7% (95% CI: 35.4%–46.2%) and 7.7% (95% CI: 5.1%–11.4%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of post-LTx AKI (p = 0.81). The pooled estimated in-hospital or 30-day mortality, and 1-year mortality rates of patients with post-LTx AKI were 16.5% (95% CI: 10.8%–24.3%) and 31.1% (95% CI: 22.4%–41.5%), respectively. Post-LTx AKI and severe AKI requiring RRT were associated with significantly higher mortality with pooled ORs of 2.96 (95% CI: 2.32–3.77) and 8.15 (95%CI: 4.52–14.69), respectively. Compared to those without post-LTx AKI, recipients with post-LTx AKI had significantly increased risk of liver graft failure and chronic kidney disease with pooled ORs of 3.76 (95% CI: 1.56–9.03) and 2.35 (95% CI: 1.53–3.61), respectively. Conclusion: The overall estimated incidence rates of post-LTx AKI and severe AKI requiring RRT are 40.8% and 7.0%, respectively. There are significant associations of post-LTx AKI with increased mortality and graft failure after transplantation. Furthermore, the incidence of post-LTx AKI has remained stable over the ten years of the study.

scholarly journals Urine Cadmium as a Risk Factor for Osteoporosis and Osteopenia: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Dong Li ◽  
HaoJie Lin ◽  
Min Zhang ◽  
Jing Meng ◽  
LiYou Hu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Subgroup Analysis ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Review Of The Literature ◽  
High Quality ◽  
Heterogeneity Test ◽  
Increased Risk ◽  
Urine Cadmium ◽  
The Relationship

Background: As society ages, the incidence of osteoporosis increases. In several studies, cadmium (Cd) is thought to be related to osteoporosis. However, there are conflicting reports about the relationship between Cd and the risk of osteoporosis and osteopenia. Therefore, the purpose of this meta-analysis was to explore the relationship between Cd and osteoporosis and osteopenia.Methods: Through a review of the literature, articles published in PubMed as of December 2020 were identified and the references of related publications and reviews were reviewed. Ultimately, 17 eligible articles were selected to determine the relationship between blood and urine Cd concentrations for the risk of osteoporosis or osteopenia. In this study, we performed a classification analysis, heterogeneity test, subgroup analysis, and evaluated publication bias.Results: A total of 17 studies were included, including seven on blood Cd and 10 on urine Cd. By combining the odds ratio (OR) and 95% confidence interval (CI) for the lowest and highest categories, the odds ratio of blood Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.21 (95% CI: 0.84–1.58) and that of urine Cd concentration that increased the risk of osteoporosis or osteopenia was OR 1.80 (95% CI: 1.42–2.18), and the results of the subgroup analysis were also consistent.Conclusions: Our research indicates that while urine cadmium (Cd) concentration may be related to increased risk of osteoporosis and osteopenia, blood Cd concentration may not. Therefore, compared to blood Cd concentration, urine Cd concentration may be more reliable as a risk factor for osteoporosis and osteopenia. This result should be interpreted with caution. Currently. research on the relationship between Cd concentration and osteoporosis and osteopenia is limited, thus, further large, high-quality prospective studies are required to elucidate the relationship between Cd concentration and osteoporosis and osteopenia.

scholarly journals Acute Kidney Injury in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 66 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Kaewput ◽  
Natanong Thamcharoen ◽  
Tarun Bathini ◽  
Kanramon Watthanasuntorn ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Significant Negative Correlation ◽  
Incidence Rates ◽  
Random Effects Model ◽  
Total Hip ◽  
Cochrane Database ◽  
Potential Improvement ◽  
Hip Arthroplasties

Background: The number of total hip arthroplasties (THA) performed across the world is growing rapidly. We performed this meta-analysis to evaluate the incidence of acute kidney injury (AKI) in patients undergoing THA. Methods: A literature search was performed using MEDLINE, EMBASE and Cochrane Database from inception until July 2018 to identify studies assessing the incidence of AKI (using standard AKI definitions of RIFLE, AKIN, and KDIGO classifications) in patients undergoing THA. We applied a random-effects model to estimate the incidence of AKI. The protocol for this meta-analysis is registered with PROSPERO (no. CRD42018101928). Results: Seventeen cohort studies with a total of 24,158 patients undergoing THA were enrolled. Overall, the pooled estimated incidence rates of AKI and severe AKI requiring dialysis following THA were 6.3% (95% CI: 3.8%–10.2%) and 0.5% (95% CI: 0.1%–2.3%). Subgroup analysis based on the countries by continent was performed and demonstrated the pooled estimated incidence of AKI following THA of 9.2% (95% CI: 5.6%–14.8%) in Asia, 8.1% (95% CI: 4.9%–13.2%) in Australia, 7.4% (95% CI: 3.2%–16.3%) in Europe, and 2.8% (95% CI: 1.2%–17.0%) in North America. Meta-regression of all included studies showed significant negative correlation between incidence of AKI following THA and study year (slope = −0.37, p <0.001). There was no publication bias as assessed by the funnel plot and Egger’s regression asymmetry test with p = 0.13 for the incidence of AKI in patients undergoing THA. Conclusion: The overall estimated incidence rates of AKI and severe AKI requiring dialysis in patients undergoing THA are 6.3% and 0.5%, respectively. There has been potential improvement in AKI incidence for patients undergoing THA over time.

scholarly journals Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

Medicines ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 109 ◽  
Author(s):  
Panupong Hansrivijit ◽  
Ploypin Lertjitbanjong ◽  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Narothama Aeddula ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Adult Population ◽  
Kidney Injury ◽  
Membrane Oxygenation ◽  
Risk Of Mortality ◽  
Cochrane Database

Background: Acute kidney injury (AKI) is a well-established complication of extra-corporal membrane oxygenation (ECMO) in the adult population. The data in the pediatric and neonatal population is still limited. Moreover, the mortality risk of AKI among pediatric patients requiring ECMO remains unclear. Thus, this meta-analysis aims to assess the incidence of AKI, AKI requiring renal replacement therapy and AKI associated mortality in pediatric/neonatal patients requiring ECMO. Methods: A literature search was performed utilizing MEDLINE, EMBASE, and the Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring renal replacement therapy (RRT) and the risk of mortality among pediatric patients on ECMO with AKI. Random-effects meta-analysis was used to calculate the pooled incidence of AKI and the odds ratios (OR) for mortality. Results: 13 studies with 3523 pediatric patients on ECMO were identified. Pooled incidence of AKI and AKI requiring RRT were 61.9% (95% confidence interval (CI): 39.0–80.4%) and 40.9% (95%CI: 31.2–51.4%), respectively. A meta-analysis limited to studies with standard AKI definitions showed a pooled estimated AKI incidence of 69.2% (95%CI: 59.7–77.3%). Compared with patients without AKI, those with AKI and AKI requiring RRT while on ECMO were associated with increased hospital mortality ORs of 1.70 (95% CI, 1.38–2.10) and 3.64 (95% CI: 2.02–6.55), respectively. Conclusions: The estimated incidence of AKI and severe AKI requiring RRT in pediatric patients receiving ECMO are high at 61.9% and 40.9%, respectively. AKI among pediatric patients on ECMO is significantly associated with reduced patient survival.

scholarly journals Vancomycin Area Under the Curve and Acute Kidney Injury: A Meta-analysis

2019 ◽  
Vol 69 (11) ◽  
pp. 1881-1887 ◽  
Author(s):  
Doaa M Aljefri ◽  
Sean N Avedissian ◽  
Nathaniel J Rhodes ◽  
Michael J Postelnick ◽  
Kevin Nguyen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Monitoring Strategy ◽  
Case Control Studies ◽  
Time Curve ◽  
The Impact ◽  
The Relationship

Abstract Background This study analyzed the relationship between vancomycin area under the concentration-time curve (AUC) and acute kidney injury (AKI) reported across recent studies. Methods A systematic review of PubMed, Medline, Scopus, and compiled references was conducted. We included randomized cohort and case-control studies that reported vancomycin AUCs and risk of AKI (from 1990 to 2018). The primary outcome was AKI, defined as an increase in serum creatinine of ≥0.5 mg/L or a 50% increase from baseline on ≥2 consecutive measurements. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Primary analyses compared the impact of AUC cutpoint (greater than ~650 mg × hour/L) and AKI. Additional analysis compared AUC vs trough-guided monitoring on AKI incidence. Results Eight observational studies met inclusion/exclusion criteria with data for 2491 patients. Five studies reported first-24-hour AUCs (AUC0-24) and AKI, 2 studies reported 24- to 48-hour AUCs (AUC24-48) and AKI, and 2 studies reported AKI associated with AUC- vs trough-guided monitoring. AUC less than approximately 650 mg × hour/L was associated with decreased AKI for AUC0-24 (OR, 0.36 [95% CI, .23–.56]) as well as AUC24-48 (OR, 0.45 [95% CI, .27–.75]). AKI associated with the AUC monitoring strategy was significantly lower than trough-guided monitoring (OR, 0.68 [95% CI, .46–.99]). Conclusions AUCs measured in the first or second 24 hours and lower than approximately 650 mg × hour/L may result in a decreased risk of AKI. Vancomycin AUC monitoring strategy may result in less vancomycin-associated AKI. Additional investigations are warranted.

scholarly journals An Association Between Hyperchloremia and Acute Kidney Injury in Patients With Acute Ischemic Stroke

2020 ◽  
Vol 10 (4) ◽  
pp. 250-256
Author(s):  
J. Tyler Haller ◽  
Keaton Smetana ◽  
Michael J. Erdman ◽  
Todd A. Miano ◽  
Heidi M. Riha ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Acute Ischemic Stroke ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Matched Cohort ◽  
Increased Risk ◽  
The Relationship

Background and Purpose: While an association between hyperchloremia and worse outcomes, such as acute kidney injury and increased mortality, has been demonstrated in hemorrhagic stroke, it is unclear whether the same relationship exists after acute ischemic stroke. This study aims to determine the relationship between moderate hyperchloremia (serum chloride ≥115 mmol/L) and acute kidney injury in patients with ischemic stroke. Methods: This is a multicenter, retrospective, propensity-matched cohort study of adults admitted for acute ischemic stroke. The primary objective was to determine the relationship between moderate hyperchloremia and acute kidney injury, as defined by the Acute Kidney Injury Network criteria. Secondary objectives included mortality and hospital length of stay. Results: A total of 407 patients were included in the unmatched cohort (332 nonhyperchloremia and 75 hyperchloremia) and 114 patients (57 in each group) were matched based upon propensity scores. In the matched cohort, hyperchloremia was associated with an increased risk of acute kidney injury (relative risk 1.91 [95% confidence interval 1.01-3.59]) and a longer hospital length of stay (16 vs 12 days; P = .03). Mortality was higher in the hyperchloremia group (19.3% vs 10.5%, P = .19), but this did not reach statistical significance. Conclusions: In this study, hyperchloremia after ischemic stroke was associated with increased rates of acute kidney injury and longer hospital length of stay. Further research is needed to determine which interventions may increase chloride levels in patients with acute ischemic stroke and the association between hyperchloremia and clinical outcomes.

scholarly journals Systematic Review and Meta-analysis of the Association of Acute Kidney Injury with the Concomitant Use of Vancomycin and Piperacillin-Tazobactam in Children

2019 ◽  
Vol 63 (12) ◽  
Author(s):  
Markos Kalligeros ◽  
Spyridon A. Karageorgos ◽  
Fadi Shehadeh ◽  
Ioannis M. Zacharioudakis ◽  
Eleftherios Mylonakis
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Publication Bias ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Beta Lactam ◽  
Beta Lactam Antibiotic ◽  
Increased Risk ◽  
Lactam Antibiotic

ABSTRACT Concomitant use of vancomycin plus piperacillin-tazobactam (TZP) has been associated with increased risk of acute kidney injury (AKI) in hospitalized adults. In this systematic review and meta-analysis, we searched PubMed and EMBASE for pediatric studies examining this hypothesis, with reference to vancomycin monotherapy or in combination with another beta-lactam antibiotic. Of 1,381 nonduplicate studies, 10 met our inclusion criteria. We performed a random-effects meta-analysis, based on crude odds ratios (ORs), and we accounted for both quality of included studies and publication bias. In primary analysis, concomitant vancomycin and TZP use yielded a statistically significant association with the development of AKI. More specifically, children with AKI had higher odds of having been exposed to vancomycin plus TZP than to vancomycin monotherapy (OR, 8.15; 95% confidence interval [CI], 3.49 to 18.99) or to vancomycin plus any other beta-lactam antibiotic (OR, 3.48; 95% CI, 2.71 to 4.46). On the basis of the results of the Newcastle-Ottawa scale quality assessment, a secondary analysis that included only higher-quality studies (6 of 10 studies) again yielded higher odds of exposure to vancomycin plus TZP than to vancomycin plus another beta-lactam antibiotic (OR, 3.76; 95% CI, 2.56 to 5.51). Notably, even after controlling for possible publication bias, our results remained statistically significant (OR, 3.09; 95% CI, 2.30 to 4.14). In conclusion, the concomitant use of vancomycin and TZP could be associated with AKI development and the clinical significance of this potential association needs to be studied further in the pediatric population.

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