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10.1371/journal.pone.0196088 http://scihub22266oqcxt.onion/10.1371/journal.pone.0196088 C5915682!5915682 !29689116     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29689116 &cmd=llinks): Failed to open stream: HTTP request failed! 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Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials |pdf=|usr=}}{{29689116 }} gab.com Text Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials JO: PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=29689116 #FOAvip BACKGROUND: Furosemide is the most common loop diuretic used worldwide. The off-label administration of furosemide bolus(es) for the prevention or to reverse acute kidney injury (AKI) is widespread but not supported by available evidence. We conducted a meta-analysis of randomized trials (RCTs) to investigate whether bolus furosemide to prevent or treat AKI is detrimental on patients' survival. METHODS: Electronic databases were searched through October 2017 for RCTs comparing bolus furosemide administration versus any comparator in patients with or at risk for AKI. The primary endpoint was all-cause longest follow-up mortality. Secondary endpoints included new or worsening AKI, receipt of renal replacement therapy, length of hospital stay, and peak serum creatinine after randomization. RESULTS: A total of 28 studies randomizing 3,228 patients were included in the analysis. We found no difference in mortality between the two groups (143/892 [16%] in the furosemide group versus 141/881 [16%] in the control group; odds ratio [OR], 0.84; 95% confidence interval [CI], 0.63 to 1.13; p = 0.25). No significant differences in secondary outcomes were found. A significant improvement in survival was found in the subgroup of patients receiving furosemide bolus(es) as a preventive measure (43/613 [7.0%] versus 67/619 [10.8%], OR 0.62; 95% CI, 0.41 to 0.94; p = 0.03). CONCLUSIONS: Intermittent furosemide administration is not associated with an increased mortality in patients with or at risk for AKI, although it may reduce mortality when used as a preventive measure. Future high-quality RCTs are needed to define the role of loop diuretics in AKI prevention and management. TRIAL REGISTRATION: The study protocol was registered on PROSPERO database for systematic reviews (Registration no. CRD42017078607 - http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078607). Twit Text FOAVip Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials ????PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=29689116 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29689116 #FOAvip English Wikipedia <ref>{{Cite pmid|29689116 }}</ref> Intermittent furosemide administration in patients with or at risk for acute kidney injury: Meta-analysis of randomized trials #MMPMID29689116 Bove T ; Belletti A ; Putzu A ; Pappacena S ; Denaro G ; Landoni G ; Bagshaw SM ; Zangrillo A PLoS One 2018[]; 13 (4 ): e0196088 PMID29689116 show ga BACKGROUND: Furosemide is the most common loop diuretic used worldwide. The off-label administration of furosemide bolus(es) for the prevention or to reverse acute kidney injury (AKI) is widespread but not supported by available evidence. We conducted a meta-analysis of randomized trials (RCTs) to investigate whether bolus furosemide to prevent or treat AKI is detrimental on patients' survival. METHODS: Electronic databases were searched through October 2017 for RCTs comparing bolus furosemide administration versus any comparator in patients with or at risk for AKI. The primary endpoint was all-cause longest follow-up mortality. Secondary endpoints included new or worsening AKI, receipt of renal replacement therapy, length of hospital stay, and peak serum creatinine after randomization. RESULTS: A total of 28 studies randomizing 3,228 patients were included in the analysis. We found no difference in mortality between the two groups (143/892 [16%] in the furosemide group versus 141/881 [16%] in the control group; odds ratio [OR], 0.84; 95% confidence interval [CI], 0.63 to 1.13; p = 0.25). No significant differences in secondary outcomes were found. A significant improvement in survival was found in the subgroup of patients receiving furosemide bolus(es) as a preventive measure (43/613 [7.0%] versus 67/619 [10.8%], OR 0.62; 95% CI, 0.41 to 0.94; p = 0.03). CONCLUSIONS: Intermittent furosemide administration is not associated with an increased mortality in patients with or at risk for AKI, although it may reduce mortality when used as a preventive measure. Future high-quality RCTs are needed to define the role of loop diuretics in AKI prevention and management. TRIAL REGISTRATION: The study protocol was registered on PROSPERO database for systematic reviews (Registration no. CRD42017078607 - http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078607). |Acute Kidney Injury/blood/*drug therapy/*prevention & control [MESH] |Creatinine/blood [MESH] |Diuretics/*administration & dosage/therapeutic use [MESH] |Electronic Health Records [MESH] |Furosemide/*administration & dosage/therapeutic use [MESH] |Humans [MESH] |Length of Stay [MESH] |Randomized Controlled Trials as Topic [MESH] |Renal Replacement Therapy [MESH] |Survival Analysis [MESH]Intermittent furosemide administration in patients with or at risk for(epmc).pdf DeepDyve Pubget Overpricing