What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis.

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acute kidney injury 6 nephrologydiseases
chronic kidney disease 4 nephrologydiseases

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acute kidney injury 99 Title: BMJ OpenWhat are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury ? A systematic review and meta-analysisPenny WhitingAndrew MordenLaurie A TomlinsonFergus CaskeyThomas
acute kidney injury 609 4/2017AbstractObjectivesTo summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI).DesignSystematic review and meta-analysis of randomised and non-randomised studies.ParticipantsAdults
acute kidney injury 2902 involving temporary discontinuation of medications to prevent or minimise the severity, or consequences, of acute kidney injury (AKI).This is a topic of major importance due to interventions currently being implemented to reduce
acute kidney injury 19712 trials.Table 2GRADE evidence profile: risks and benefits of temporarily discontinuing medications to prevent acute kidney injury Quality assessmentNumber of patientsEffectStudiesRisk of biasInconsistencyIndirectnessImprecisionOther
acute kidney injury 19927 biasInconsistencyIndirectnessImprecisionOther considerationsContinuationDiscontinuationRelative(95% CI)Absolute(95% CI)QualityIncidence of acute kidney injury 3 RCTsNot seriousNot seriousNot seriousSerious*Publication bias strongly suspected†27/248 (10.9%)21/274
acute kidney injury 20844 of bias as did not control for confounding.RR, Risk ratio.Figure 2Forest plot showing the risk of acute kidney injury in those who stopped medication prior to procedure compared with those who continued medication.Secondary
chronic kidney disease 11495 but one study[16] restricted inclusion to patients deemed at higher risk of AKI such as those with chronic kidney disease (3 studies),[17][18][20] diabetes (1 study)[21] or a set of criteria that defined patients at high risk
chronic kidney disease 15220 angiotensin-converting enzyme inhibitors; AKI, acute kidney infection; ARB, angiotensin receptor blockers; CKD, chronic kidney disease ; NSAIDs, non-steroidal anti-inflammatory drugs; RCT, randomised controlled trial; SCr, serum creatinine.Risk
chronic kidney disease 26286 incomplete recovery from AKI (ie, failure of serum creatinine concentration to return to baseline), chronic kidney disease and all-cause mortality.To further quantify the limitations of the studies, we conducted a formal risk
chronic kidney disease 27971 consideration of temporarily stopping ACEI and ARBs in adults having iodinated contrast agents if they have chronic kidney disease with an eGFR <40 mL/min/1.73 m2, and in adults, children and young people with diarrhoea, vomiting

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