The clinical efficacy of continuous renal replacement in the
treatment of acute pancreatitis: a meta-analysis of randomized
controlled trials
Sijia Ma1, Mingming Zhao1, Zhiyu
Pan1, Jiao Fan1,
Zhang
XueXue2 Yu Zhang1*
1 Department of Nephrology, Xiyuan Hospital, China Academy of Chinese
Medical Sciences, Beijing, China
2
Department
of endocrinology, China Academy of Chinese Medical Sciences, Beijing,
China
*Correspondence:
zhangyu8225@126.com
Sijia Ma, Mingming Zhao are shared first authors and contributed equally
to the article.
Abstract: Objective:The purpose of this study was to investigate the effect of continuous
renal replacement therapy(CRRT) on patients with
acute
pancreatitis(AP). Methods: A comprehensive search of seven
databases without language restrictions includes PubMed, Cochrane
Library, Scopus, Embase, Web of Science, China National Knowledge
Infrastructure(CNKI) and Wan fang database. Randomized controlled trials
(RCTs) for the treatment of acute pancreatitis with CRRT were searched.
All the included literatures were published before December 2020. Two
review authors independently selected the study and extracted the data
according to the inclusion criteria. A third review author will and
discuss with the first two review authors and resolve the differences.
Weighted mean difference(WMD), risk ratio (RR), and 95% confidence
interval (CI) were used for estimating the clinical efficacy of AP in
CRRT and control treatment. Results: Fifty-three RCTs met the
inclusion criteria and were used in the meta-analysis, with a total of
3,382 effective samples. A comprehensive review of the system shows that
the mortality rate of the CRRT group was significantly lower than that
of the control group, and the difference was statistically
significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the
patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78,
95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6
clearance effect. According to liver function, the patients using CRRT
had lower ALT and AST levels. In the same way, according to renal
function, the patients using CRRT had lower SCr (WMD=-94.28,
95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT
also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003).
Moreover, Results shown no statistical difference in Serum potassium
level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two
groups. Conclusions : Our findings suggest that treatment with
CRRT for acute pancreatitis may be more beneficial than conventional
treatment. However, high-quality studies with a larger sample size are
still needed to confirm our results.
Key words: Acute pancreatitis; Continuous renal replacement
therapy; The prognosis; Meta-analysis; APACHE Ⅱ scores; Serum markers;
Inflammatory factors; Liver and kidney function