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Incidencia de lesión renal aguda inducida por medio de contraste asociado al uso continuo de inhibidores del sistema renina angiotensina aldosterona: revisión sistemática y meta-análisis
| dc.contributor | Bareño Silva, Jose | |
| dc.contributor | Panche Castellanos, Karen | |
| dc.contributor.advisor | Pinto Ramirez, Jessica Liliana | |
| dc.creator | Carrillo Villamizar, Ruben Dario | |
| dc.creator | Piñeros Vargas, Jairo Enrique | |
| dc.creator | Currea Manrique, Camilo Antonio | |
| dc.creator.degree | Magíster en epidemiología | es |
| dc.creator.degreeLevel | Maestría | |
| dc.creator.degreetype | Presencial | es |
| dc.date.accessioned | 2022-12-01T14:19:04Z | |
| dc.date.available | 2022-12-01T14:19:04Z | |
| dc.date.created | 2022-11-23 | |
| dc.description | Introducción: La lesión renal aguda inducida por contraste (LRA - PC) es un desenlace importante en los ingresos a hospitalización y en Unidad de Cuidado Intensivo, la cual se asocia al incremento de morbilidad, estancia hospitalaria, mortalidad y costos. Sin embargo, no se conoce con exactitud si el uso continuo de IECA/BRA en exposición a medios de contraste aumenta la incidencia de LRA. Objetivo: Determinar la incidencia de Lesión Renal Aguda inducida por medio de contraste asociada al uso continuo de Inhibidores de renina angiotensina aldosterona. Métodos: Revisión sistemática basada en las guías PRISMA. Los criterios de elegibilidad: Estudios de tipo ensayo clínico aleatorizados (ECA) y de cohorte prospectiva con pacientes ≥ 16 años, hospitalizados en sala general, en tratamiento crónico con IECA/BRA ≥ 1 mes; en los cuales se continúa o suspende transitoriamente antes de ser expuestos a un medio de contraste arterial. Los criterios de exclusión: Pacientes con trasplante renal, enfermedad renal crónica en estadio 5, hipercalemia, choque, inestabilidad hemodinámica o embarazadas. La búsqueda fue conducida entre 1 enero al 30 abril de 2022 con las palabras claves en PUBMED, MEDLINE, EMBASE, WEB OF SCIENCE, LILACS Y literatura gris. Se evaluó la calidad del reporte con la lista de chequeo de CONSORT o STROBE y el riesgo potencial de sesgos con ROBIS-I o ROBIS-I de Cochrane. La síntesis y el análisis estadístico de los datos se realizó en el software EPIDAT 3.1 y JAMOVI Resultados: Se incluyeron 5 estudios, uno de cohorte prospectiva y cuatro ECA, una muestra de 803 participantes: 389 pacientes continuaron IECA/BRA y 414 pacientes suspendieron el tratamiento. Los estudios utilizaron la misma definición de LRA - PC, 4 estudios retiraron el tratamiento de IECA/BRA, 24 horas antes del procedimiento y un estudio lo hizo 36 horas antes. El efecto global estimó continuar IECA/BRA antes de un procedimiento con medio de contraste arterial como factor de riesgo de LRA – PC con un RR 1,7 IC: 1.09 - 2.65. Discusión: Esta revisión sistemática soporta que el retiro de IECA/BRA antes de un procedimiento de contraste arterial puede ser considerada en la práctica clínica, teniendo en cuenta el riesgo beneficio individualizado de cada paciente. Sin embargo, la limitación más importante de estudio es el sesgo de publicación. Conclusión: La incidencia de LRA – PC puede aumentar con el uso continuo de IECA/BRA durante el procedimiento con medio de contraste arterial. | es |
| dc.description.abstract | Introduction: Contrast-induced acute kidney injury (AKI - CP) is an important outcome in hospitalization and Intensive Care Unit admissions, which is associated with increased morbidity, hospital stay, mortality and costs. However, it is not known exactly whether the continuous use of ACEI/BRA in exposure to contrast media increases the incidence of AKI. Objective: To determine the incidence of contrast media-induced acute kidney injury associated with continuous use of renin angiotensin aldosterone inhibitors. Methods: Systematic review based on PRISMA guidelines. Eligibility criteria: randomized clinical trial (RCT) and prospective cohort type studies with patients ≥ 16 years, hospitalized in general ward, on chronic ACEI/ARB therapy ≥ 1 month; in which it is continued or transiently discontinued before being exposed to arterial contrast medium. Exclusion criteria: patients with renal transplantation, stage 5 chronic kidney disease, hyperkalemia, shock, hemodynamic instability or pregnant women. The search was conducted between January 1 to April 30, 2022 with the keywords PUBMED, MEDLINE, EMBASE, The Virtual Health Library, WEB OF SCIENCE, LILACS and gray literature. The quality of the report was assessed with the CONSORT or STROBE checklist and the potential risk of bias with ROBIS-I or Cochrane ROBIS-I. Data synthesis and statistical analysis was performed in EPIDAT 3.1 and JAMOVI software. Results: 5 studies were included, one prospective cohort and four RCTs, a sample of 803 participants: 389 patients continued ACEI/BRA and 414 patients discontinued treatment. The studies used the same definition of AKI-PC, four studies withdrew ACEI/ARB treatment 24 hours before the procedure and one study 36 hours before. The overall effect estimated continuing ACEI/ARB before a procedure with arterial contrast medium as a risk factor for AKI-PC with a RR 1.7 CI: 1.09 - 2.65. Discussion: This systematic review supports that withdrawal of ACEI/BRA before an arterial contrast procedure can be considered in clinical practice, taking into account the individualized risk-benefit of each patient. However, the most important limitation of the study is publication bias. Conclusion: The incidence of AKI-PC may increase with continued use of ACEI/ARB during the arterial contrast procedure. Translated with www.DeepL.com/Translator (free version) | es |
| dc.format.extent | 154 pp | es |
| dc.format.mimetype | application/pdf | es |
| dc.identifier.doi | https://doi.org/10.48713/10336_37579 | |
| dc.identifier.uri | https://repository.urosario.edu.co/handle/10336/37579 | |
| dc.language.iso | spa | es |
| dc.publisher | Universidad del Rosario | spa |
| dc.publisher | Universidad CES. Facultad de Economía | |
| dc.publisher.department | Escuela de Medicina y Ciencias de la Salud | spa |
| dc.publisher.program | Maestría en Epidemiología | spa |
| dc.rights | Atribución-NoComercial-SinDerivadas 2.5 Colombia | * |
| dc.rights.accesRights | info:eu-repo/semantics/openAccess | es |
| dc.rights.acceso | Abierto (Texto Completo) | es |
| dc.rights.licencia | EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos. | spa |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | * |
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| dc.source.instname | instname:Universidad del Rosario | |
| dc.source.reponame | reponame:Repositorio Institucional EdocUR | |
| dc.subject | Lesión renal aguda | es |
| dc.subject | Inhibidores de la enzima convertidora de angiotensina (IECAS) | es |
| dc.subject | Bloqueadores de los receptores de la angiotensina II (BRA) | es |
| dc.subject | Medios de contraste | es |
| dc.subject | Angiografía | es |
| dc.subject | Interrupción del tratamiento | es |
| dc.subject.ddc | Ciencias médicas, Medicina | es |
| dc.subject.keyword | Acute kidney injury | es |
| dc.subject.keyword | Angiotensin-converting enzyme inhibitors (ACE inhibitors) | es |
| dc.subject.keyword | Angiotensin II receptor blockers (ARBs) | es |
| dc.subject.keyword | Contrast media | es |
| dc.subject.keyword | Angiography | es |
| dc.subject.keyword | Withdrawing treatment | es |
| dc.title | Incidencia de lesión renal aguda inducida por medio de contraste asociado al uso continuo de inhibidores del sistema renina angiotensina aldosterona: revisión sistemática y meta-análisis | es |
| dc.title.TranslatedTitle | Incidence of contrast medium-induced acute kidney injury associated with the continued use of renin angiotensin aldosterone system inhibitors: systematic review and meta- analysis | es |
| dc.type | masterThesis | es |
| dc.type.document | Tesis | es |
| dc.type.hasVersion | info:eu-repo/semantics/acceptedVersion | |
| dc.type.spa | Tesis | es |
| local.department.report | Escuela de Medicina y Ciencias de la Salud | es |
