Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials. | Wiedermann et al. Critical Care 2010 14 R191 http content 14 5 R191 c CRITICAL CARE RESEARCH Open Access Hyperoncotic colloids and acute kidney injury a meta-analysis of randomized trials 1 2 1 I- 7 3 2 Christian J Wiedermann Stefan Dunzendorfer Luigi U Gaioni Francesco Zaraca Michael Joannidis Abstract Introduction It has been hypothesized that hyperoncotic colloids might contribute to acute kidney injury AKI . However the validity of this hypothesis remains unclear. Methods A meta-analysis was conducted of randomized controlled trials evaluating AKI after infusion of hyperoncotic albumin and hydroxyethyl starch HES solutions. Mortality was a secondary endpoint. Eligible trials were sought by multiple methods and the pooled odds ratios OR for AKI and death and 95 confidence intervals CI were computed under a random effects model. Results Eleven randomized trials with a total of 1220 patients were included 7 evaluating hyperoncotic albumin and 4 hyperoncotic HES. Clinical indications were ascites surgery sepsis and spontaneous bacterial peritonitis. Hyperoncotic albumin decreased the odds of AKI by 76 OR CI P while hyperoncotic HES increased those odds by 92 OR CI P . Parallel effects on mortality were observed with hyperoncotic albumin reducing the odds of death by 48 OR CI P and hyperoncotic HES raising those odds by 41 OR CI P . Conclusions This meta-analysis does not support the hypothesis that hyperoncotic colloid solutions per se injure the kidney. Renal effects appear instead to be colloid-specific with albumin displaying renoprotection and HES showing nephrotoxicity. Introduction The potential for beneficial or deleterious renal effects is a key consideration in the selection and use of colloid solutions for clinical fluid management. In a systematic review albumin was found to protect the kidney whereas the carbohydrate-based artificial colloids hydroxyethyl .
