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Interventions for protecting renal function in the perioperative period
M Zacharias1, I C S Gilmore, G P Herbison
1Anaesthesia & Intensive Care, Dunedin Hospital, Great King Street, Dunedin, Otago, New Zealand. mathew.zacharias@stonebow.otago.ac.nz
The Cochrane Database of Systematic Reviews
|July 22, 2005
Summary
Current surgical methods lack reliable evidence for protecting kidney function. More high-quality studies are needed, especially for patients with pre-existing renal dysfunction undergoing surgery.
Area of Science:
- Nephrology
- Surgical Medicine
- Pharmacology
Background:
- Surgical procedures pose a risk to kidney function.
- Various interventions, including dopamine, diuretics, and ACE inhibitors, have been explored for perioperative renal protection.
Purpose of the Study:
- To review randomized controlled trials (RCTs) evaluating methods for protecting renal function during surgery.
- To assess outcomes such as renal failure, mortality, and renal function tests.
Main Methods:
- Systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE) and hand-searched journals.
- Inclusion of 37 RCTs involving adult surgical patients receiving perioperative renal protection interventions.
- Subgroup and sensitivity analyses were performed based on intervention type, surgical procedure, and patient renal status.
Main Results:
- Data from 37 studies and 1227 patients were analyzed.
- Interventions included pharmaceutical agents and hydration fluids.
- Significant heterogeneity across studies precluded drawing definitive conclusions on effectiveness.
Conclusions:
- No reliable evidence supports the effectiveness of current surgical interventions in protecting kidneys.
- Further high-quality research is essential, particularly focusing on patients with pre-existing renal dysfunction.