Table 2. Outcomes measures of early versus late RRT initiation.
| Outcome or Subgroup | Group A: critically ill patients with AKI | Group B: non-critically ill patients with AKI | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Studies | No. of Patients | Study Reference No | Effect Estimate (95% CI) | p | Studies | No. of Patients | Study Reference No | Effect Estimate (95% CI) | p | |
| Primary Outcomes: early versus late RRT initiation on mortality | ||||||||||
| All studies | 31 | 5408 | 7-9,12,18,28-30,32,34,35,38-41,43,44, 462,463,47,48,50-59 | OR, 0.40 (0.32 to 0.48) | 0.001 | 20 | 4290 | 10,11,13-17,19-23,31,33,36,37,42,45,461,49 | OR, 1.07 (0.79 to 1.45) | 0.000 |
| Subgroup stratified by the definition of early according to time criteria and biochemical indicators on mortality | ||||||||||
| Time: Early RRT <12h | 7 | 639 | 9,12,28-30,32,56 | OR, 0.28 (0.16 to 0.49) | 0.093 | 5 | 1003 | 10,13,21,31,42 | OR, 0.86 (0.58 to 1.29) | 0.201 |
| Time: Early RRT <24h | 4 | 534 | 34,35,53,54 | OR, 0.37 (0.25 to 0.54) | 0.691 | 4 | 782 | 11,22,33,36 | OR, 0.72 (0.43 to 1.19) | 0.097 |
| Time: Early RRT <48h | 3 | 1531 | 7,55,57 | OR, 0.55 (0.39 to 0.77) | 0.236 | 3 | 368 | 17,19,37 | OR, 0.82 (0.18 to 3.79) | 0.012 |
| Time: Early RRT <72h | 3 | 999 | 18,38,58 | OR, 0.45 (0.29 to 0.69) | 0.145 | 1 | 28 | 16 | OR, 36.0 (4.33 to 299.02) | NE |
| Time: Early RRT >72h | 4 | 465 | 8,39,40,52 | OR, 0.32 (0.14 to 0.74) | 0.015 | 0 | NE | NE | NE | NE |
| Biochemicl indicators | 10 | 1240 | 41,43,44, 462,463-48,50,51,59 | OR, 0.40 (0.25 to 0.64) | 0.009 | 7 | 2109 | 14,15,20,23,45, 461,49 | OR, 1.46 (0.96 to 2.23) | 0.008 |
| Subgroup stratified by surgical versus mixed medical admissions on mortality | ||||||||||
| Surgical | 9 | 1506 | 8,9,18,30,32,34,38,44,54 | OR, 0.33 (0.22 to 0.48) | 0.053 | 6 | 602 | 16,17,19,22,31,33 | OR, 0.71 (0.24 to 2.07) | 0.000 |
| Mixed medical | 22 | 3902 | 7,12,28,29,35,39,41,43,462,463-48,50-53,55-59 | OR, 0.43 (0.34 to 0.54) | 0.004 | 14 | 3688 | 10,11,13-15,20,21,23,36,37,42,45,461,49 | OR, 1.22 (0.91 to 1.63) | 0.000 |
| Subgroup stratified by RRT modality on mortality | ||||||||||
| Mixed | 14 | 3442 | 7,9,12,28,29,35,38,41,43,48,53,54,55,57 | OR, 0.45 (0.35 to 0.57) | 0.009 | 6 | 2495 | 13,14,20,21,45,49 | OR, 1.32 (0.86 to 2.03) | 0.000 |
| CRRT | 14 | 1771 | 8,18,32,34,39,40,44,462,463,47,50,52,55,58 | OR, 0.40 (0.30 to 0.54) | 0.152 | 12 | 1544 | 10,11,15-17,22,31,33,36,37,42, 461 | OR, 0.92 (0.58 to 1.46) | 0.017 |
| IHD | 3 | 255 | 30,51,59 | OR, 0.11 (0.03 to 0.43) | 0.098 | 2 | 251 | 19,23 | OR, 0.56 (0.04 to 8.73) | 0.000 |
| Secondary outcomes: ICU and Hospital LOS | ||||||||||
| ICU LOS | 8 | 862 | 28,34,35,38,41, 462,463,53 | MD, −0.41 (−0.55 to −0.27) | 0.000 | 4 | 336 | 17,19,31, 461 | MD, −1.47 (−1.71 to −1.22) | 0.000 |
| Hospital LOS | 6 | 755 | 8,28,34,38,39,54 | MD, −0.36 (−0.51 to −0.21) | 0.000 | 3 | 287 | 17,19,31 | MD, −1.07 (−1.31 to −0.82) | 0.415 |
LEGEN: OR odds ratio, 95% CI confidence interval, P Test for Heterogeneity, MD mean difference, RRT renal replacement therapy, ICU Intensive Care Unit, CRRT continuous renal replacement therapy, IHD intermittent hemodialysis, Mixed CRRT and/or IHD and/or other RRT modality, LOS length of stay, NE not evaluable.