Limited Clinical Utility of Remote Ischemic Conditioning in Renal Transplantation: A Meta-Analysis of Randomized Controlled Trials

Autor: Meng Zhu, Xiao-Fei Gao, Changcheng Zhou, Tian-Ze Lu, Yu-Zheng Ge, Wen-Tao Yao, Kai-Wei Song, Ming-Hao Li, Shengli Zhang, Hui Xin, Li-Guo Geng, Min Wang, Liuhua Zhou, Jia-Geng Zhu, Ruipeng Jia, Yunpeng Zhu, Ran Wu
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Graft Rejection
Critical Care and Emergency Medicine
lcsh:Medicine
030204 cardiovascular system & hematology
030230 surgery
Cochrane Library
Kidney
Kidney Function Tests
Vascular Medicine
law.invention
0302 clinical medicine
Mathematical and Statistical Techniques
Randomized controlled trial
law
Ischemia
Medicine and Health Sciences
Renal Transplantation
lcsh:Science
Ischemic Preconditioning
Kidney transplantation
Randomized Controlled Trials as Topic
Cerebral Ischemia
Multidisciplinary
Graft Survival
Hospitals
Neurology
Reperfusion Injury
Meta-analysis
Physical Sciences
Renal Ischemia
Statistics (Mathematics)
Research Article
medicine.medical_specialty
Drug Research and Development
Renal function
Subgroup analysis
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Urinary System Procedures
03 medical and health sciences
Internal medicine
medicine
Humans
Clinical Trials
Statistical Methods
Immunosuppression Therapy
Pharmacology
Transplantation
business.industry
lcsh:R
Organ Transplantation
medicine.disease
Kidney Transplantation
Randomized Controlled Trials
Health Care
Health Care Facilities
Relative risk
Reperfusion
lcsh:Q
Clinical Medicine
business
Mathematics
Meta-Analysis
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 1, p e0170729 (2017)
ISSN: 1932-6203
Popis: Objective We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. Methods PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI). The statistical significance and heterogeneity were assessed with both Z-test and Q-test. Results A total of six RCTs including 651 recipients, were eventually identified. Compared to the controls, RIC could reduce the incidence of delayed graft function (DGF) after kidney transplantation (random-effects model: RR = 0.89; fixed-effect model: RR = 0.84). However, the decrease did not reveal statistical significance. The subgroup analysis by RIC type demonstrated no significant difference among the three interventions in protecting renal allografts against DGF. Furthermore, no significant difference could be observed in the incidence of acute rejection, graft loss, 50% fall in serum creatinine, as well as the estimated glomerular filtration rate and hospital stay between the RIC and Control groups. Conclusions This meta-analysis suggested that RIC might exert renoprotective functions in human kidney transplantation, and further well-designed RCTs with large sample size are warranted to assess its clinical efficacy.
Databáze: OpenAIRE
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