However, as the difficulty faced by Prowle et al.,[28] prolonged duration of washout period in chronic statin user is unethical. In patients undergoing CABG, the preoperative treatment of placebo instead of statins may also be unethical since this is
against the guideline of ACCF/AHA. Furthermore, the estimated sample size required to power the study to detect the difference in the hard outcome of AKI requiring dialysis may be large. In the paucity of large scale RCTs, meta-analysis of large cohort studies with good methodological quality may provide additional evidence for this important clinical issue. Our meta-analysis and systematic review showed that preoperative statin therapy may be associated with reduced risk for postoperative STI571 AKI and AKI requiring RRT. The protection for postoperative AKI is also discernible in patients undergoing isolated CABG. However, the protective effect was insignificant when only the five RCTs were combined. The inclusion of mainly observational studies, varied types of surgery, a heterogeneous definition of AKI, and lack of complete description of preoperative statin administration weaken the robustness of this meta-analysis. Future randomized trials are warranted for this important clinical question. Complete search terms (1) The first query, the population query, was composed of the following exploded
RG-7204 headings and terms: (‘surgical procedures, operative’[MeSH Terms] OR surgery[Text Word] OR operation[Text Word]). “
“The risk of asymptomatic haematuria and/or proteinuria development into chronic progressive glomerulonephritis (CPG) is unclear. The indications for renal biopsy and follow-up on these asymptomatic children remain controversial. A multicenter, retrospective study was see more performed to investigate the renal histological features of school-age children
with asymptomatic urine abnormalities. A total of 112 asymptomatic children’s renal biopsy data were studied. Most of the children (71%) received a renal biopsy because of isolated microscopic haematuria (IH), and these children were predominantly (60%) proven to have only mild lesions in the glomeruli. Approximately 30% of the children were biopsied because of asymptomatic proteinuria with or without microscopic haematuria (HP or isolated asymptomatic proteinuria (IP)), and these children were mostly (44–83%) indicated to have CPG, such as IgA nephropathy, focal segmental glomerulosclerosis, and Alport syndrome. The junior high school students had a greater percentage of HP than the primary school children. IgA nephropathy was the most common diagnosis in children who received renal biopsy because of HP. Our findings indicate that IP and especially HP may have a high risk of development into CPG. IH, however, has a relatively low risk of severe histological lesions.