Bicarbonate-versus lactate-buffered solutions for hemodiafiltration in acute renal failure:a meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND:Hemodialysis therapy is an important means for the treatment of acute renal failure, which aims to remove excess water and toxins and maintain acid-base balance of a patient, creating conditions for medication and nutrition therapy while avoiding multiple organ failure. OBJECTIVE:To compare bicarbonate-and lactate-buffered solutions for acute continuous hemodiafiltration in acute renal failure. METHODS:A computer-based search was performed in PubMed, EMBASE, SCI, Cochrane Library, Chinese Biomedical Literature Database, China Journal Ful Text Database, Chinese Medical Association Journals for randomized control trials related to bicarbonate-versus lactate-buffered solutions for hemodiafiltration in acute renal failure published before January 2014. The quality of the included studies was evaluated by Cochrane Handbook, and data were analyzed by RevMan 5.1 from the Cochrane Col aboration. RESULTS AND CONCLUSION:Four studies (171 patients) met inclusion criteria. Overal , patients treated with bicarbonate-buffered solutions had fewer cardiovascular complications and symptomatic hypotension events as wel as lower serum lactate levels than patients who received lactate-buffered solutions (P<0.05). There were no differences in mortality, serum bicarbonate levels, serum creatinine, serum pH, carbon dioxide partial pressure. The current evidence shows that patients undergoing bicarbonate-buffered solutions may experience fewer cardiovascular complications and symptomatic hypotension. Given the limited research, it is insufficient to recommend for clinical use.