Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/10332
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dc.contributor.authorBagshaw, Sean Men
dc.contributor.authorDelaney, Anthonyen
dc.contributor.authorHaase, Michaelen
dc.contributor.authorGhali, William Aen
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2015-05-15T23:45:08Z
dc.date.available2015-05-15T23:45:08Z
dc.date.issued2007-03-01en
dc.identifier.citationCritical Care and Resuscitation; 9(1): 60-8en
dc.identifier.govdoc17352669en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/10332en
dc.description.abstractLoop diuretics are commonly used in critically ill patients with acute renal failure (ARF), but their effect on clinical outcome remains uncertain. We systematically reviewed the literature comparing loop diuretics with control in the management of ARF.Studies were identified by search of MEDLINE, EMBASE, and the Cochrane Controlled Clinical Trials Register, and review of proceedings from selected scientific meetings and clinical trial registries, and bibliographies of retrieved citations. We selected randomised controlled trials (RCTs) comparing loop diuretics with control in patients with ARF. Data were extracted in duplicate by two independent reviewers on study characteristics, quality and outcomes. Primary outcomes were mortality, need for renal replacement therapy (RRT) and renal recovery. Secondary outcomes were change to urine output, serum potassium level and acid-base status, duration of ARF or RRT, length of hospital stay and toxicity.Of 62 studies reviewed, five RCTs, enrolling 555 patients, were eligible and analysed. These trials enrolled a mix of patients, but only two included critically ill patients. Overall trial quality was low. There was no statistical difference in mortality (odds ratio [OR], 1.28; 95% CI, 0.89-1.84; P=0.18) or renal recovery (OR, 0.88; 95% CI, 0.59-1.31; P=0.5) with use of loop diuretics compared with control. However, loop diuretics were associated with a shorter duration of RRT (weighted mean difference, ?1.4 days; 95% CI, ?0.2 to ?2.3 days; P=0.02), shorter time to spontaneous decline in serum creatinine level (weighted mean difference, ?2.1 days; 95% CI, ?0.4 to ?3.7 days; P=0.01) and a greater increase in urine output from baseline (OR, 2.6; 95% CI, 1.4-4.9; P=0.004). Insufficient data were available on acid-base status, hospital length of stay or health costs. Four studies reported toxicity, most commonly transient tinnitus and deafness.Loop diuretics were not associated with improved mortality or rate of independence from RRT, but were associated with shorter duration of RRT and increased urine output. However, these findings have limited relevance to critically ill patients. The relative paucity of high-quality data assessing the value of loop diuretics in ARF for the critically ill suggests a need for a suitably powered randomised trial.en
dc.language.isoenen
dc.subject.otherAcid-Base Equilibriumen
dc.subject.otherAcute Kidney Injury.blood.drug therapy.mortality.urineen
dc.subject.otherCreatinine.blooden
dc.subject.otherCritical Illnessen
dc.subject.otherData Interpretation, Statisticalen
dc.subject.otherFemaleen
dc.subject.otherFurosemide.administration & dosage.adverse effects.therapeutic useen
dc.subject.otherHumansen
dc.subject.otherLength of Stayen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherOdds Ratioen
dc.subject.otherPotassium.blooden
dc.subject.otherRandomized Controlled Trials as Topicen
dc.subject.otherRenal Replacement Therapyen
dc.subject.otherSodium Potassium Chloride Symporter Inhibitors.administration & dosage.adverse effects.therapeutic useen
dc.subject.otherSulfonamides.administration & dosage.adverse effects.therapeutic useen
dc.subject.otherTime Factorsen
dc.subject.otherTreatment Outcomeen
dc.titleLoop diuretics in the management of acute renal failure: a systematic review and meta-analysis.en
dc.typeJournal Articleen
dc.identifier.journaltitleCritical Care and Resuscitationen
dc.identifier.affiliationDepartment of Intensive Care, Austin Hospital, Melbourne, VIC, Australiaen
dc.description.pages60-8en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/17352669en
dc.type.austinJournal Articleen
local.name.researcherBellomo, Rinaldo
item.languageiso639-1en-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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