Table 1 The characteristics of early and late RRT studies included in the meta-analysis
Study | Year | Study design | RRT modality | Definition of early and late RRT | Mortality at 28Â days Deaths/patients (n/n (%)) | Total | OR(95% CI) | Quality score | ||
|---|---|---|---|---|---|---|---|---|---|---|
Early RRT | Late RRT | Early RRT | Late RRT | |||||||
Bouma [23] | 2002 | RCT | CRRT | UOP <30Â mL/h within 12Â h | Plasma urea level >40Â mmol/L after 12Â h | 11/35 (31.4) | 9/36 (25.0) | 71 | 1.38 (0.49, 3.88) | M |
Combes [17] | 2015 | RCT | CRRT/IHD | RRT initiation within 24Â h post cardiac surgery in shock requiring high-dose catecholamine | Classic indication for RRT, life-threatening metabolic derangements | 40/112 (35.7) | 40/112 (35.7) | 224 | 1.00 (0.58, 1.73) | H |
Crescenzi [18] | 2015 | RCT | CRRT | Within 12Â h of UOP <0.5Â mL/kg/h | After 12Â h on the basis of persistent (>6Â h of UOP <0.5Â mL/kg/h) oliguria | 28/46 (60.9) | 10/13 (76.9) | 59 | 0.47 (0.11, 1.93) | L |
Demirkilic [24] | 2004 | Retrospective cohort | CRRT | RRT initiation within 24Â h after surgery when UOP <100Â mL within consecutive 8Â h | RRT initiation after 24Â h post-surgery when Cr level exceeded 5Â mg/dL or potassium level exceeded 5.5Â mEq/L | 8/34 (23.5) | 15/27 (55.6) | 61 | 0.25 (0.08, 0.74) | 6 |
Durmaz [25] | 2003 | RCT | IHD | Serum Cr rise >10% from pre-op level within 48Â h of surgery | Serum Cr rise >50% from pre-op level or UOP <400Â mL over 24Â h of surgery | 1/21 (4.8) | 7/23 (30.4) | 44 | 0.11 (0.01, 1.03) | L |
Elahi [26] | 2004 | Retrospective cohort | CRRT | RRT initiation within 24 h after surgery when UOP <100 mL within 8 h consecutively, despite furosemide infusion | RRT initiation after 24 h post-surgery when urea ≥30 mmol/L, serum Cr ≥250 mol/L or serum K ≥6 mEq/L | 8/36 (22.2) | 12/28 (42.9) | 64 | 0.38 (0.13, 1.13) | 6 |
Fernandez [27] | 2011 | Retrospective cohort | CRRT/IHD | Within 72Â h after surgery | After 72Â h post-surgery | 54/101 (53.2) | 82/102 (80.4) | 203 | 0.28 (0.15, 0.52) | 7 |
Helmut [28] | 1987 | Retrospective cohort | IHD | Before first hemodialysis within 48Â h after surgery | Within 48 h after the first hemodialysis | 9/21 (42.9) | 10/15 (66.7) | 36 | 0.38 (0.09, 1.49) | 9 |
Iyem [29] | 2009 | Prospective cohort | CRRT | RRT initiation within 48 h when UOP ≤0.5 mL/kg/h post open-heart surgery | RRT initiation after 48 h when UOP ≤0.5 mL/ kg/h and 50% increase in baseline urea and Cr post open-heart surgery | 5/95 (5.2) | 6/90 (6.6) | 185 | 0.78 (0.23, 2.64) | 7 |
Ji [30] | 2011 | Retrospective cohort | CRRT | Within 12 h of UOP ≤0.5 mL/kg/h postoperatively | 12 h after UOP ≤0.5 mL/kg/h postoperatively | 3/34 (8.8) | 9/24 (37.5) | 58 | 0.16 (0.04, 0.68) | 6 |
Kleinknecht [31] | 1972 | Retrospective cohort | IHD | Early and frequent hemodialysis to keep blood urea <200Â mg/100Â mL | Blood urea more than 350Â mg/100Â mL or severe presence of electrolyte abnormality | 4/10 (40.0) | 5/10 (50.0) | 20 | 0.67 (0.11, 3.92) | 7 |
Manche [32] | 2008 | Retrospective cohort | IHD | RRT initiation within 48Â h after surgery when UOP <0.5Â mL/kg/min | RRT initiation after 48Â h post-surgery when all other supportive treatments failed | 14/56 (25.0) | 13/15 (87.0) | 71 | 0.05 (0.01, 0.26) | 6 |
Sugahara [33] | 2004 | RCT | CRRT | Within 12Â h of UOP <30Â mL/h | After 12Â h of UOP <20Â mL/h | 2/14 (14.3) | 12/14 (85.7) | 28 | 0.03 (0.00, 0.23) | M |
Szu-Yuan Li [19] | 2014 | Retrospective cohort | CRRT | Within 12Â h of UOP <240Â mL | UOP <240Â mL after 12Â h | 44/97 (61.9) | 33/45 (82.2) | 142 | 0.30 (0.14, 0.65) | 8 |
Xiao-Mei Yang [20] | 2016 | Retrospective cohort | IHD | RRT initiation within 24Â h after surgery when AKI present in absence of traditional indications for RRT | RRT initiation after 24Â h post-surgery when there were traditional indications for RRT | 20/59 (33.9) | 80/154 (51.9) | 213 | 0.47 (0.25, 0.89) | 7 |