Heterogeneity in the definition of major adverse kidney events: a scoping review.

Autor: Maeda A; Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.; Department of Emergency and Critical Care Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan., Inokuchi R; Department of Emergency and Critical Care Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.; Department of Clinical Engineering, The University of Tokyo Hospital, Tokyo, Japan., Bellomo R; Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.; Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, VIC, Australia.; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.; Department of Intensive Care, The Royal Melbourne Hospital, Melbourne, Australia., Doi K; Department of Emergency and Critical Care Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. kentdoi@m.u-tokyo.ac.jp.
Jazyk: angličtina
Zdroj: Intensive care medicine [Intensive Care Med] 2024 Jul; Vol. 50 (7), pp. 1049-1063. Date of Electronic Publication: 2024 May 27.
DOI: 10.1007/s00134-024-07480-x
Abstrakt: Acute kidney injury (AKI) is associated with persistent renal dysfunction, the receipt of dialysis, dialysis dependence, and mortality. Accordingly, the concept of major adverse kidney events (MAKE) has been adopted as an endpoint for assessing the impact of AKI. However, applied criteria or observation periods for operationalizing MAKE appear to vary across studies. To evaluate this heterogeneity for MAKE evaluation, we performed a systematic scoping review of studies that employed MAKE as an AKI endpoint. Four major academic databases were searched, and we identified 122 studies with increasing numbers over time. We found marked heterogeneity in applied criteria and observation periods for MAKE across these studies, with some even lacking a description of criteria. Moreover, 13 different observation periods were employed, with 30 days and 90 days as the most common. Persistent renal dysfunction was evaluated by estimated glomerular filtration rate (34%) or serum creatinine concentration (48%); however, 37 different definitions for this component were employed in terms of parameters, cut-off criteria, and assessment periods. The definition for the dialysis component also showed significant heterogeneity regarding assessment periods and duration of dialysis requirement (chronic vs temporary). Finally, MAKE rates could vary by 7% [interquartile range: 1.7-16.7%] with different observation periods or by 36.4% with different dialysis component definitions. Our findings revealed marked heterogeneity in MAKE definitions, particularly regarding component assessment and observation periods. Dedicated discussion is needed to establish uniform and acceptable standards to operationalize MAKE in terms of selection and applied criteria of components, observation period, and reporting criteria for future trials on AKI and related conditions.
(© 2024. The Author(s).)
Databáze: MEDLINE
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