危重症患者高氯血症对急性肾损伤影响的Meta分析

Effect of hyperchloremia on acute kidney injury in critically ill patients:a Meta-analysis

目的评价在重症监护室危重症患者中高氯血症对急性肾损伤的影响。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方、维普数据库从建库至2022年9月29日公开发表的关于高氯血症与危重症患者结局相关的文献。利用文献提供的调整或未调整的优势比(OR)及95%置信区间(95%CI)统计量,应用R语言软件进行Meta分析。结果共纳入文献15篇,包括29005例患者。Meta分析结果显示危重症患者入住重症监护室后高氯血症发生率为43%(OR=0.43,95%CI:0.30~0.56),发生高氯血症的危重症患者急性肾损伤发生风险明显增加(OR=1.35,95%CI:1.10~1.64,P<0.01),敏感性分析显示结果稳健。结论危重症患者高氯血症与急性肾损伤发生有显著相关性。

Objective To evaluate the effect of hyperchloremia on acute kidney injury(AKI)in critically ill patients in a non-elective intensive care unit(ICU).Methods The databases of PubMed,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang and VIP were accessed for searching the published literature on hyperchloremia associated with outcomes in critically ill patients up to September 29,2022.Meta-analysis was performed by applying R language software using adjusted or unadjusted odds ratio(OR)and 95%confidence interval(95%CI).Results A total of 15 studies involving 29005 patients were included for Meta-analysis.Meta-analysis showed that the incidence of hyperchloremia was 43%in critically ill patients after admission into ICU(OR=0.43,95%CI:0.30-0.56).The risk of AKI was significantly elevated in critically ill patients with hyperchloremia(OR=1.35,95%CI:1.10-1.64,P<0.01).Conclusions Hyperchloremia is significantly associated with the occurrence of AKI in critically ill patients.