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Effects of early recovery of renal function on adverse renal outcomes and mortality in patients with acute kidney injury: a systematic review and meta-analysis

  • Nephrology - Original Paper
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Abstract

Aim

This study intended to scrutinize the effect of RFR time on adverse renal outcomes and mortality and try to define the cutoff of early RFR.

Methods

We conducted a literature search from database inception to February 2023. Outcome measures incorporated the progression of CKD, delivery of RRT, incidence of composite renal outcomes, and mortality. And pooled results were depicted as odds ratio (OR) and 95% confidence interval (CI).

Results

A total of 11 studies were finally selected (507,989 patients, mean follow-up, 3.89 years). The results exhibited that the crude mortality was lower in patients with early RFR (OR = 0.39, 95% CI: 0.16–0.95, P = 0.037). In addition, patients with early RFR had a lower incidence of progression to CKD (OR = 0.38, 95% CI: 0.17–0.85, P < 0.018), RRT (OR = 0.37, 95% CI: 0.20–0.71, P = 0.03), and composite renal outcomes (OR = 0.18, 95% CI: 0.15–0.20, P < 0.001). CKD progression-related events were significantly higher in patients whose renal function recovered after 7 days (OR = 0.69, 95% CI: 0.47–1.09, P = 0.112) than in those whose renal function recovered within 7 days (OR = 0.23, 95% CI: 0.06–0.92, P = 0.038), and the risk of RRT was lower in patients who recovered within 7 days (OR = 0.32, 95% CI: 0.15–0.66, P = 0.002) than in those who recovered after 7 days (OR = 0.72, 95% CI: 0.17–3.09, P = 0.654) or longer.

Conclusion

Patients with early RFR had a lower risk of CKD progression, RRT, and composite renal outcomes, as well as lower crude mortality than those without early recovery, despite no marked difference in 30-day, 90-day, and 1-year mortality. We speculated that 7 days may be used as a cutoff for early RFR.

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Funding

This work was supported by the Hebei Provincial Specialty Capacity Building and Specialty Leader Training Project [(2018)674], the Hebei Provincial Excellent Talents in Clinical Medicine Training Project [(2019)139], the Hebei province medical technology tracking project (GZ2020013), the Hebei Clinical Medical Research Centre Project (20577701D), the project of the Hebei Provincial Excellent Health Talents and High-Quality Development of Public Hospitals [(2022)180], and the project of Natural Science Foundation of Hebei Province (H2023206385).

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Authors and Affiliations

  1. Departments of Nephrology, Hebei Key Laboratory of Vascular Calcifcation in Kidney Disease, Hebei Clinical Research Center for Chronic Kidney Disease, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050000, People’s Republic of China

    Yaling Bai, Yajing Li, JingJing Jin, Meijuan Cheng, Shenglei Zhang, Xinyue Yang & Jinsheng Xu

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  1. Yaling Bai
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Correspondence to Jinsheng Xu.

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Yaling Bai and Yajing Li have contributed to this work equally. The authors state that there is no conflict of interest.

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Bai, Y., Li, Y., Jin, J. et al. Effects of early recovery of renal function on adverse renal outcomes and mortality in patients with acute kidney injury: a systematic review and meta-analysis. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03974-1

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