Table 3.
Meta-analyses regarding pharmacologic renal protection for preventing acute kidney injury after cardiac surgery.
| Agent | Author/ publication year |
Study type (RCT/ observational study) |
Outcome | Patients (Drug/control, n) | Pooled effect size (OR, 95% CI) | p value | I 2 (heterogeneity) |
|---|---|---|---|---|---|---|---|
| Dopamine | Zacharias et al. 2013 [79] | 10 | AKI | 541 | 1.36 (0.44, 4.23) | Not reported | Not reported |
| Fenoldopam | Zangrillo et al. 2012 [81] | 5 (5/0) | AKI | 202/207 | 0.41 (0.23, 0.74) | 0.003 | 0% |
| Fenoldopam | Zangrillo et al. 2012 [81] | 4 (4/0) | RRT | 183/188 | 0.67 (0.10, 4.48) | 0.68 | 62% |
| Statin | Liakopoulos et al. 2008 [100] | 5 (2/3) | AKI | 4236/2172 | 0.78 (0.46, 1.31) | 0.34 | 58.3% |
| Sodium bicarbonate | Bailey et al. 2015 [89] | 3 (3/0) | ∗ | 877 | 1.11 (0.77, 1.60) | 0.45 | Not reported |
| Sodium bicarbonate | Tie et al. 2014 [91] | 5 (5/0) | AKI | 1079 | 0.99 (0.78, 1.24) | 0.911 | 56.1% |
| Mannitol | Yang et al. 2014 [101] | 4 (4/0) | † | 94/93 | −2.35 (−7.46, 2.75) | 0.37 | 0% |
| N-acetylcysteine | Ho and Morgan 2009 [94] | 10 | RRT | 485/487 | 1.04 (0.45, 2.37) | 0.9 | 3.3% |
| N-acetylcysteine | Patel et al. 2011 [97] | 4 (4/0) | AKI | 453/450 | 0.86 (0.66, 1.13) | 0.29 | 0% |
| N-acetylcysteine | Patel et al. 2011 [97] | 7 (7/0) | RRT | 503/499 | 0.98 (0.50, 1.92) | 0.96 | 5% |
| Atrial natriuretic peptide | Patel et al. 2011 [97] | 1 (1/0) | AKI | 251/253 | 0.35 (0.23, 0.76) | 0.005 | One study |
| Atrial natriuretic peptide | Patel et al. 2011 [97] | 5 (5/0) | RRT | 427/426 | 0.24 (0.10, 0.56) | 0.001 | 0% |
| Brain natriuretic peptide | Patel et al. 2011 [97] | 2 (2/0) | AKI | 186/187 | 0.40 (0.21, 0.76) | 0.005 | 40% |
| Brain natriuretic peptide | Patel et al. 2011 [97] | 2 (2/0) | RRT | 64/69 | 0.80 (0.18, 3.64) | 0.78 | 0% |
| Steroids adults | Scrascia et al. 2014 [99] | 7 (7/0) | AKI | 291/289 | 1.13 (0.53, 2.43) | Not reported | 18.3% |
| MECC | Scrascia et al. 2014 [99] | 6 (6/0) | AKI | 391/427 | 0.47 (0.18, 1.25) | Not reported | 0% |
| Leukofiltration | Scrascia et al. 2014 [99] | 4 (4/0) | AKI | 157/157 | 0.18 (0.05, 0.64) | Not reported | 0% |
AKI: acute kidney injury; RRT: renal replacement therapy.
∗Postoperative increase in serum creatinine concentration of greater than 25% or 0.5 mg/dL within the first five postoperative days.
†Change of serum creatinine concentration.