{"title":"Risk factors for acute kidney injury in patients with severe acute pancreatitis: A systematic review and meta-analysis.","authors":"Min Liu, Yuqiong Xiao, Anqiao Wang","doi":"10.1177/03913988241289070","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to identify the risk factors for acute kidney injury (AKI) in patients with severe acute pancreatitis (SAP).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using the PubMed, Embase and Cochrane Library databases for case-control studies comparing the clinical characteristics of patients with SAP with and without AKI. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using fixed- or random-effects models, based on heterogeneity.</p><p><strong>Results: </strong>Five studies involving 795 patients with SAP were included, of whom 173 (21.8 %) developed AKI. All studies were of high quality according to the NOS. Among the 17 potential risk factors that were analysed, a history of alcohol consumption (OR = 2.36, 95% CI = 0.54-10.43, <i>p</i> < 0.001), elevated serum amylase (OR = 4.50, 95% CI = 1.77-11.43, <i>p</i> = 0.002) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 1.57, 95% CI = 0.49-2.64, <i>p</i> = 0.004) were significantly associated with an increased risk of AKI. However, hypertension (OR = 1.14, 95% CI = 0.60-2.16, <i>p</i> = 0.69) and diabetes (OR = 1.88, 95% CI = 0.51-6.95, <i>p</i> = 0.34) were not significantly associated with AKI risk. Based on funnel plots, no obvious publication bias was detected.</p><p><strong>Conclusions: </strong>A history of alcohol consumption, elevated serum amylase and APACHE II score are significant risk factors for AKI in patients with SAP. For early intervention, clinical physicians should be vigilant about the risk of AKI in patients with SAP with these factors. More high-quality studies are needed to validate these findings and explore other potential risk factors.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988241289070"},"PeriodicalIF":1.4000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Artificial Organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/03913988241289070","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
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Abstract
Objective: This systematic review and meta-analysis aimed to identify the risk factors for acute kidney injury (AKI) in patients with severe acute pancreatitis (SAP).
Methods: A comprehensive literature search was conducted using the PubMed, Embase and Cochrane Library databases for case-control studies comparing the clinical characteristics of patients with SAP with and without AKI. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using fixed- or random-effects models, based on heterogeneity.
Results: Five studies involving 795 patients with SAP were included, of whom 173 (21.8 %) developed AKI. All studies were of high quality according to the NOS. Among the 17 potential risk factors that were analysed, a history of alcohol consumption (OR = 2.36, 95% CI = 0.54-10.43, p < 0.001), elevated serum amylase (OR = 4.50, 95% CI = 1.77-11.43, p = 0.002) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR = 1.57, 95% CI = 0.49-2.64, p = 0.004) were significantly associated with an increased risk of AKI. However, hypertension (OR = 1.14, 95% CI = 0.60-2.16, p = 0.69) and diabetes (OR = 1.88, 95% CI = 0.51-6.95, p = 0.34) were not significantly associated with AKI risk. Based on funnel plots, no obvious publication bias was detected.
Conclusions: A history of alcohol consumption, elevated serum amylase and APACHE II score are significant risk factors for AKI in patients with SAP. For early intervention, clinical physicians should be vigilant about the risk of AKI in patients with SAP with these factors. More high-quality studies are needed to validate these findings and explore other potential risk factors.
目的本系统综述和荟萃分析旨在确定重症急性胰腺炎（SAP）患者急性肾损伤（AKI）的风险因素：使用 PubMed、Embase 和 Cochrane Library 数据库对病例对照研究进行了全面的文献检索，比较了有 AKI 和无 AKI 的 SAP 患者的临床特征。纳入研究的质量采用纽卡斯尔-渥太华量表（NOS）进行评估。根据异质性，采用固定效应或随机效应模型计算汇总的几率比（ORs）及95%置信区间（CIs）：共纳入五项研究，涉及 795 名 SAP 患者，其中 173 人（21.8%）发生了 AKI。根据NOS标准，所有研究的质量都很高。在分析的 17 个潜在风险因素中，饮酒史（OR = 2.36，95% CI = 0.54-10.43，p = 0.002）和急性生理学和慢性健康评估 II (APACHE II) 评分（OR = 1.57，95% CI = 0.49-2.64，p = 0.004）与 AKI 风险增加显著相关。然而，高血压（OR = 1.14，95% CI = 0.60-2.16，p = 0.69）和糖尿病（OR = 1.88，95% CI = 0.51-6.95，p = 0.34）与 AKI 风险无显著相关性。根据漏斗图，未发现明显的发表偏倚：结论：饮酒史、血清淀粉酶升高和 APACHE II 评分是 SAP 患者发生 AKI 的重要风险因素。为了早期干预，临床医生应警惕存在这些因素的 SAP 患者发生 AKI 的风险。还需要更多高质量的研究来验证这些发现并探索其他潜在的风险因素。
期刊介绍：
The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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