Effect of acute kidney injury care bundles on patient prognosis: a systematic review and meta-analysis.

IF 2.4 4区医学 Q2 UROLOGY & NEPHROLOGY

BMC Nephrology Pub Date : 2025-09-26 DOI:10.1186/s12882-025-04349-z

Ying Huang, Lingling Guan, Chao Sun

{"title":"Effect of acute kidney injury care bundles on patient prognosis: a systematic review and meta-analysis.","authors":"Ying Huang, Lingling Guan, Chao Sun","doi":"10.1186/s12882-025-04349-z","DOIUrl":null,"url":null,"abstract":"Background: Acute kidney injury (AKI) is a severe complication among hospitalized patients. This study aimed to investigate the effect of care bundles on the prognosis of AKI patients.Methods: Electronic databases were searched from January 2012 to December 2023. Randomized controlled trials and cohort studies evaluating the effect of AKI care bundles were included. A meta-analysis using a random-effects model was conducted to explore the efficacy of the AKI care bundle.Results: A total of 12 studies with 30,152 participants were included. Based on the random-effects model, the AKI care bundles significantly improved the AKI severity (RR: 0.77, 95% CI: 0.60-0.98, I2 = 64%) and the need for renal replacement therapy (RR: 0.66, 95% CI: 0.46-0.94, I2 = 14%). However, our study did not find a statistically significant impact of AKI care bundle on the incidence of AKI incidence (RR: 0.95, 95% CI: 0.81-1.13, I2 = 87%), major adverse kidney events (RR: 1.06, 95% CI: 0.65-1.73), in-hospital mortality (RR: 0.93, 95% CI: 0.81-1.07, I2 = 19%), and length of hospital stay (MD: -0.16, 95% CI: -0.80, 0.47).Conclusion: This systematic review indicates that the implementation of the AKI bundle is a promising care model for AKI patients. There is a need for more high-quality prospective studies on AKI and patients at high risk of AKI to further determine feasible and standardized models of AKI bundle care.Clinical trial number: Not applicable.","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"519"},"PeriodicalIF":2.4000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465485/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12882-025-04349-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Acute kidney injury (AKI) is a severe complication among hospitalized patients. This study aimed to investigate the effect of care bundles on the prognosis of AKI patients.

Methods: Electronic databases were searched from January 2012 to December 2023. Randomized controlled trials and cohort studies evaluating the effect of AKI care bundles were included. A meta-analysis using a random-effects model was conducted to explore the efficacy of the AKI care bundle.

Results: A total of 12 studies with 30,152 participants were included. Based on the random-effects model, the AKI care bundles significantly improved the AKI severity (RR: 0.77, 95% CI: 0.60-0.98, I² = 64%) and the need for renal replacement therapy (RR: 0.66, 95% CI: 0.46-0.94, I² = 14%). However, our study did not find a statistically significant impact of AKI care bundle on the incidence of AKI incidence (RR: 0.95, 95% CI: 0.81-1.13, I² = 87%), major adverse kidney events (RR: 1.06, 95% CI: 0.65-1.73), in-hospital mortality (RR: 0.93, 95% CI: 0.81-1.07, I² = 19%), and length of hospital stay (MD: -0.16, 95% CI: -0.80, 0.47).

Conclusion: This systematic review indicates that the implementation of the AKI bundle is a promising care model for AKI patients. There is a need for more high-quality prospective studies on AKI and patients at high risk of AKI to further determine feasible and standardized models of AKI bundle care.

Clinical trial number: Not applicable.

查看原文本刊更多论文

急性肾损伤护理包对患者预后的影响：系统回顾和荟萃分析。

背景：急性肾损伤（AKI）是住院患者中一种严重的并发症。本研究旨在探讨护理包对AKI患者预后的影响。方法：检索2012年1月~ 2023年12月的电子数据库。包括评估AKI护理包效果的随机对照试验和队列研究。采用随机效应模型进行荟萃分析，探讨AKI护理包的疗效。结果：共纳入12项研究，30152名受试者。基于随机效应模型，AKI护理包显著改善了AKI严重程度（RR: 0.77, 95% CI: 0.60-0.98, I2 = 64%）和肾脏替代治疗需求（RR: 0.66, 95% CI: 0.46-0.94, I2 = 14%）。然而，我们的研究并未发现AKI护理包对AKI发病率（RR: 0.95, 95% CI: 0.81-1.13, I2 = 87%）、主要肾脏不良事件（RR: 1.06, 95% CI: 0.65-1.73）、住院死亡率（RR: 0.93, 95% CI: 0.81-1.07, I2 = 19%）和住院时间（MD: -0.16, 95% CI: -0.80, 0.47）的发生率有统计学意义的影响。结论：本系统综述表明，AKI bundle的实施是AKI患者的一种有希望的护理模式。需要对AKI和AKI高风险患者进行更多高质量的前瞻性研究，以进一步确定AKI一揽子护理的可行和标准化模式。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.30

自引率

0.00%

发文量

375

审稿时长

3-8 weeks

期刊介绍： BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.