Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Systematic review: The use of diuretics and dopamine in acute renal failure: a systematic review of the evidence. | Kellum Critical Care 1997 1 53 http c CRITICAL CARE RESEARCH Open Access Systematic review The use of diuretics and dopamine in acute renal failure a systematic review of the evidence John A Kellum Abstract Objective To evaluate the impact of diuretics and dopamine for both the prevention and treatment of renal dysfunction in the acute care setting. Study identification and selection Studies were identified via MEDLINE and through bibliographies of primary and review articles. Articles were then screened by the author for studies addressing the use of diuretics or dopamine in the prevention and or treatment of renal dysfunction. Data abstraction and literature appraisal From individual studies data were abstracted regarding design features population intervention and outcomes. Studies were graded by levels according to their design. Results A total of 10 studies using diuretics and 30 involving dopamine were identified. Level I evidence exists against the use of diuretics for radiocontrast-induced acute tubular necrosis and loop diuretics given after vascular surgery. There is level II evidence that diuretics do not improve outcome in patients with established acute renal failure. Level II evidence also exists against the use of dopamine in the prevention of acute tubular necrosis in multiple subsets of patients. Conclusions Routine use of diuretics or dopamine for the prevention of acute renal failure cannot be justified on the basis of available evidence. Introduction The term acute renal failure ARF has been used to encompass a wide variety of clinical disorders ranging from glomerulonephritis to prerenal azotemia. It is generally defined as a rapid decline within hours to weeks in glomerular filtration rate GFR and retention of nitrogenous waste products. Each underlying disorder has its own unique pathophysiology and separate set of etiologies. Furthermore many of these clinical syndromes have specific treatments. Accordingly it is not possible to
