Se realizaron búsquedas en Medline, Cochrane Library y Web of Science de ensayos aleatorizados de RenalGuard frente a estrategias estándar de hidratación periprocedimiento. Según la literatura disponible, la evidencia sobre el RenalGuard no es concluyente, por lo que hemos realizado un metanálisis utilizando una construcción bayesiana.
El RenalGuard, que suministra una adecuada hidratación combinada con diuresis inducida por furosemida, es una alternativa a las estrategias convencionales de hidratación. La nefropatía inducida por contraste (NIC) es una potencial complicación de los procedimientos que requieren la administración de medio de contraste yodado. In patients undergoing percutaneous cardiovascular procedures, RenalGuard was associated with a reduced risk of CA-AKI and acute pulmonary edema compared with standard periprocedural hydration strategies.
These results were consistent in multiple sensitivity analyses. The Bayesian analysis also showed that RenalGuard had a high probability of ranking first for all the secondary outcomes. No significant differences were observed for the other secondary endpoints. RenalGuard was associated with a significant relative reduction in CA-AKI (median RR, 0.54 95%CrI, 0.31-0.86) and acute pulmonary edema (median RR, 0.35 95%CrI, 0.12-0.87). A Bayesian random-effect risk ratio (RR) with corresponding 95% credibility interval (95%CrI) was calculated for each outcome. Secondary outcomes were all-cause death, cardiogenic shock, acute pulmonary edema, and renal failure requiring renal replacement therapy. We searched Medline, Cochrane Library and Web of Science for randomized trials of RenalGuard vs standard periprocedural hydration strategies. We used a Bayesian framework to perform a meta-analysis of RenalGuard as a CA-AKI preventive strategy. The evidence on RenalGuard in patients undergoing percutaneous cardiovascular procedures is sparse. RenalGuard, which provides real-time matching of intravenous hydration with furosemide-induced diuresis, is an alternative to standard periprocedural hydration strategies. Contrast-associated acute kidney injury (CA-AKI) is a potential complication of procedures requiring administration of iodinated contrast medium.
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