Cochrane · systematic review · CD013330
Non‐pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy
Tsujimoto, Y, Miki, S, Shimada, H, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
36
current version
GRADE rated
17
No studies
19
Included studies
NR
No studies 19 · 52.8%Ungraded 0 · 0%Very low 7 · 19.4%Low 10 · 27.8%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
CVVHD versus CVVH or CVVHDF for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespan CVVHD vs CVVH or CVVHDF | no estimate extracted | NR | No studies |
Death from any cause CVVHD vs CVVH or CVVHDF | RR 0.77 [0.42, 1.4] | 4 studies · 229 participants | Very low Downgraded: risk of bias |
Recovery of kidney function CVVHD vs CVVH or CVVHDF | RR 0.91 [0.37, 2.21] | 2 studies · 93 participants | Very low Downgraded: risk of bias |
Vascular access complications CVVHD vs CVVH or CVVHDF | no estimate extracted | NR | No studies |
CVVHDF versus CVVH for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespana CVVHDF vs CVVH | no estimate extracted | 1 study · 62 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of CVVHDF vs CVVH | RR 0.68 [0.52, 0.9] | 1 study · 206 participants | Very low Downgraded: risk of bias |
Recovery of kidney function CVVHDF vs CVVH | RR 1.1 [0.86, 1.41] | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Vascular access complications CVVHDF vs CVVH | no estimate extracted | NR | No studies |
Pre‐dilution versus post‐dilution (as defined by study investigators) for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespana Pre‐dilution vs post‐dilution (as defined by study investigators) | no estimate extracted | 2 studies · 47 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of Pre‐dilution vs post‐dilution (as defined by study investigators) | no estimate extracted | NR | No studies |
Recovery of kidney function Pre‐dilution vs post‐dilution (as defined by study investigators) | no estimate extracted | NR | No studies |
Vascular access complications Pre‐dilution vs post‐dilution (as defined by study investigators) | no estimate extracted | NR | No studies |
Higher blood flow versus standard blood flow for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespana Higher blood flow vs standard blood flow | no estimate extracted | 2 studies · 499 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of Higher blood flow vs standard blood flow | no estimate extracted | NR | No studies |
Recovery of kidney function Higher blood flow vs standard blood flow | no estimate extracted | NR | No studies |
Vascular access complications Higher blood flow vs standard blood flow | no estimate extracted | NR | No studies |
Long (> 20 cm) versus short (≤ 20 cm) catheter for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespana Long (> 20 cm) vs short (≤ 20 cm) catheter | no estimate extracted | 1 study · 402 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of Long (> 20 cm) vs short (≤ 20 cm) catheter | RR 1.38 [0.61, 3.11] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Recovery of kidney function Long (> 20 cm) vs short (≤ 20 cm) catheter | no estimate extracted | NR | No studies |
Vascular access complications Long (> 20 cm) vs short (≤ 20 cm) catheter | RR 0.38 [0.2, 0.72] | 1 study · 94 participants | Low Downgraded: risk of bias |
Surface‐modified versus standard double‐lumen catheter with identical geometry and flow design for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespan Surface‐modified vs standard double‐lumen catheter with identical geometry and flow design | no estimate extracted | 1 study · 262 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of Surface‐modified vs standard double‐lumen catheter with identical geometry and flow design | RR 1.08 [0.76, 1.53] | 1 study · 236 participants | Very low Downgraded: risk of bias |
Recovery of kidney function Surface‐modified vs standard double‐lumen catheter with identical geometry and flow design | RR 0.91 [0.7, 1.2] | 1 study · 236 participants | Low Downgraded: risk of bias |
Vascular access complications Surface‐modified vs standard double‐lumen catheter with identical geometry and flow design | RR 0.33 [0.09, 1.2] | 1 study · 236 participants | Low Downgraded: risk of bias |
Polyethylenimine‐treated membrane (AN69ST) versus other membranes for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespan Polyethylenimine‐treated membrane (AN69ST) vs other membranes | no estimate extracted | 2 studies · 56 participants | Low Downgraded: imprecision |
Death from any cause at day 28 of Polyethylenimine‐treated membrane (AN69ST) vs other membranes | no estimate extracted | NR | No studies |
Recovery of kidney function Polyethylenimine‐treated membrane (AN69ST) vs other membranes | no estimate extracted | NR | No studies |
Vascular access complications Polyethylenimine‐treated membrane (AN69ST) vs other membranes | no estimate extracted | NR | No studies |
Flat plate versus hollow fibre filter of the same membrane type for preventing clotting of extracorporeal circuits during CKRT
Population: people with AKI receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespan Flat plate vs hollow fibre filter of the same membrane type | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias |
Death from any cause at day 28 of Flat plate vs hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |
Recovery of kidney function Flat plate vs hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |
Vascular access complications Flat plate vs hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |
More and shorter versus standard hollow fibre filter of the same membrane type for preventing clotting of extracorporeal circuits during CKRT
Population: AKI patients receiving CKRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Circuit lifespan More and shorter vs standard hollow fibre filter of the same membrane type | no estimate extracted | 1 study · 6 participants | Low Downgraded: risk of bias |
Death from any cause at day 28 of More and shorter vs standard hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |
Recovery of kidney function More and shorter vs standard hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |
Vascular access complications More and shorter vs standard hollow fibre filter of the same membrane type | no estimate extracted | NR | No studies |