The clinical efficacy of continuous renal replacement in the treatment
of acute pancreatitis: a meta-analysis of randomized controlled trials
Abstract：Objective: The purpose of this study was to investigate the
effect of continuous renal replacement therapy(CRRT) on patients with
acute pancreatitis(AP). Methods: A comprehensive search of seven
databases without language restrictions includes PubMed, Cochrane
Library, Scopus, Embase, Web of Science, China National Knowledge
Infrastructure(CNKI) and Wan fang database. Randomized controlled trials
(RCTs) for the treatment of acute pancreatitis with CRRT were searched.
All the included literatures were published before December 2020. Two
review authors independently selected the study and extracted the data
according to the inclusion criteria. A third review author will and
discuss with the first two review authors and resolve the differences.
Weighted mean difference(WMD), risk ratio (RR), and 95% confidence
interval (CI) were used for estimating the clinical efficacy of AP in
CRRT and control treatment. Results: Fifty-three RCTs met the inclusion
criteria and were used in the meta-analysis, with a total of 3,382
effective samples. A comprehensive review of the system shows that the
mortality rate of the CRRT group was significantly lower than that of
the control group, and the difference was statistically
significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the
patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78,
95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6
clearance effect. According to liver function, the patients using CRRT
had lower ALT and AST levels. In the same way, according to renal
function, the patients using CRRT had lower SCr (WMD=-94.28,
95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT
also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003).
Moreover, Results shown no statistical difference in Serum potassium
level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups.
Conclusions: Our findings suggest that treatment with CRRT for acute
pancreatitis may be more beneficial than conventional treatment.
However, high-quality studies with a larger sample size are still needed
to confirm our results.