利尿剂用于预防和治疗急性损伤
Hiroyuki Hashimoto1, Hiroyuki Yamada2,3, Maki Murata4
1Department of Pharmacoepidemiology, Kyoto University, Kyoto, Japan.
The Cochrane database of systematic reviews
|January 29, 2025
概括
利尿剂可能会降低急性损伤 (AKI) 和置换疗法 (KRT) 的风险. 然而,用利尿剂治疗已确定的AKI的证据有限,需要进一步研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性损伤 (AKI) 是危急疾病的常见并发症,增加了发病率和死亡率.
- 利尿剂经常用于管理AKI中的液体过载和寡尿症.
- 利尿剂在AKI预防和治疗中的确切作用需要全面评估.
研究的目的:
- 系统地审查用于AKI预防的利尿剂的益处和危害.
- 系统地审查用于AKI治疗的利尿剂的益处和危害.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 搜索了科克莱恩脏和移植注册册研究到2024年5月.
- 使用GRADE方法评估偏差风险和证据确定性.
主要成果:
- 为了预防AKI,利尿剂可以减少AKI发病率 (低确定性证据) 和KRT使用 (中等确定性证据).
- 利尿剂可能会减少AKI预防中的死亡 (中度确定性证据).
- 对于AKI治疗,利尿剂在KRT使用或死亡 (低确定性证据) 中几乎没有差异,但可能会增加低血压和心律失常.
结论:
- 利尿剂在AKI预防方面可能有好处,可能减少AKI发病率和KRT需要.
- 支持用于已建立的AKI治疗的利尿剂的证据有限.
- 需要进一步的RCT来澄清利尿剂在治疗已确定的AKI中的作用.
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