Background <p>Acute kidney injury (AKI) is a severe complication among hospitalized patients. This study aimed to investigate the effect of care bundles on the prognosis of AKI patients.</p> Methods <p>Electronic databases were searched from January 2012 to December 2023. Randomized controlled trials and cohort studies evaluating the effect of AKI care bundles were included. A meta-analysis using a random-effects model was conducted to explore the efficacy of the AKI care bundle.</p> Results <p>A total of 12 studies with 30,152 participants were included. Based on the random-effects model, the AKI care bundles significantly improved the AKI severity (RR: 0.77, 95% CI: 0.60–0.98, I<sup>2</sup> = 64%) and the need for renal replacement therapy (RR: 0.66, 95% CI: 0.46–0.94, I<sup>2</sup> = 14%). However, our study did not find a statistically significant impact of AKI care bundle on the incidence of AKI incidence (RR: 0.95, 95% CI: 0.81–1.13, I<sup>2</sup> = 87%), major adverse kidney events (RR: 1.06, 95% CI: 0.65–1.73), in-hospital mortality (RR: 0.93, 95% CI: 0.81–1.07, I<sup>2</sup> = 19%), and length of hospital stay (MD: -0.16, 95% CI: -0.80, 0.47).</p> Conclusion <p>This systematic review indicates that the implementation of the AKI bundle is a promising care model for AKI patients. There is a need for more high-quality prospective studies on AKI and patients at high risk of AKI to further determine feasible and standardized models of AKI bundle care.</p> Clinical trial number <p>Not applicable.</p>

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Effect of acute kidney injury care bundles on patient prognosis: a systematic review and meta-analysis

  • Ying Huang,
  • Lingling Guan,
  • Chao Sun

摘要

Background

Acute kidney injury (AKI) is a severe complication among hospitalized patients. This study aimed to investigate the effect of care bundles on the prognosis of AKI patients.

Methods

Electronic databases were searched from January 2012 to December 2023. Randomized controlled trials and cohort studies evaluating the effect of AKI care bundles were included. A meta-analysis using a random-effects model was conducted to explore the efficacy of the AKI care bundle.

Results

A total of 12 studies with 30,152 participants were included. Based on the random-effects model, the AKI care bundles significantly improved the AKI severity (RR: 0.77, 95% CI: 0.60–0.98, I2 = 64%) and the need for renal replacement therapy (RR: 0.66, 95% CI: 0.46–0.94, I2 = 14%). However, our study did not find a statistically significant impact of AKI care bundle on the incidence of AKI incidence (RR: 0.95, 95% CI: 0.81–1.13, I2 = 87%), major adverse kidney events (RR: 1.06, 95% CI: 0.65–1.73), in-hospital mortality (RR: 0.93, 95% CI: 0.81–1.07, I2 = 19%), and length of hospital stay (MD: -0.16, 95% CI: -0.80, 0.47).

Conclusion

This systematic review indicates that the implementation of the AKI bundle is a promising care model for AKI patients. There is a need for more high-quality prospective studies on AKI and patients at high risk of AKI to further determine feasible and standardized models of AKI bundle care.

Clinical trial number

Not applicable.