重新思考利尿剂在急性肾损伤中的应用：有效预防还是虚假希望？

IF 3.8 2区医学 Q1 CRITICAL CARE MEDICINE

Journal of Intensive Care Pub Date : 2025-06-16 DOI:10.1186/s40560-025-00804-z

Hiroyuki Yamada, Maki Murata, Hiroyuki Hashimoto

{"title":"重新思考利尿剂在急性肾损伤中的应用：有效预防还是虚假希望？","authors":"Hiroyuki Yamada, Maki Murata, Hiroyuki Hashimoto","doi":"10.1186/s40560-025-00804-z","DOIUrl":null,"url":null,"abstract":"A recent meta-analysis of randomized controlled trials (with pre-specified methods and the largest sample to date) found that prophylactic diuretics significantly reduce acute kidney injury (AKI) incidence in high-risk patients but provide no benefit in treating established AKI. These findings challenge current AKI management guidelines, which generally discourage prophylactic diuretic use. However, given heterogeneity among trials and some risk of bias, caution is advised before generally altering clinical practice until further research confirms these findings.","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":"13 1","pages":"34"},"PeriodicalIF":3.8000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168346/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rethinking diuretic use in acute kidney injury: effective prevention or false hope?\",\"authors\":\"Hiroyuki Yamada, Maki Murata, Hiroyuki Hashimoto\",\"doi\":\"10.1186/s40560-025-00804-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"A recent meta-analysis of randomized controlled trials (with pre-specified methods and the largest sample to date) found that prophylactic diuretics significantly reduce acute kidney injury (AKI) incidence in high-risk patients but provide no benefit in treating established AKI. These findings challenge current AKI management guidelines, which generally discourage prophylactic diuretic use. However, given heterogeneity among trials and some risk of bias, caution is advised before generally altering clinical practice until further research confirms these findings.\",\"PeriodicalId\":16123,\"journal\":{\"name\":\"Journal of Intensive Care\",\"volume\":\"13 1\",\"pages\":\"34\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168346/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Intensive Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40560-025-00804-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40560-025-00804-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

最近的一项随机对照试验荟萃分析（使用预先指定的方法和迄今为止最大的样本）发现，预防性利尿剂可显著降低高风险患者的急性肾损伤（AKI）发生率，但对治疗已建立的AKI没有任何益处。这些发现挑战了当前AKI管理指南，该指南通常不鼓励预防性使用利尿剂。然而，考虑到试验之间的异质性和一些偏倚风险，在进一步的研究证实这些发现之前，建议在普遍改变临床实践之前谨慎行事。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Rethinking diuretic use in acute kidney injury: effective prevention or false hope?

A recent meta-analysis of randomized controlled trials (with pre-specified methods and the largest sample to date) found that prophylactic diuretics significantly reduce acute kidney injury (AKI) incidence in high-risk patients but provide no benefit in treating established AKI. These findings challenge current AKI management guidelines, which generally discourage prophylactic diuretic use. However, given heterogeneity among trials and some risk of bias, caution is advised before generally altering clinical practice until further research confirms these findings.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine

CiteScore

11.90

自引率

1.40%

发文量

审稿时长

15 weeks

期刊介绍： "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.