Please use this identifier to cite or link to this item: https://www.um.edu.mt/library/oar/handle/123456789/109897
Title: Efficacy of RenalGuard in preventing contrast-induced acute kidney injury
Authors: Chivhanganye, Michelle (2022)
Keywords: Heart -- Surgery -- Complications
Kidneys -- Wounds and injuries -- Prevention
Acute renal failure -- Prevention
Diuresis
Intravenous therapy
Issue Date: 2022
Citation: Chivhanganye, M. (2022). Efficacy of RenalGuard in preventing contrast-induced acute kidney injury (Bachelor's dissertation).
Abstract: Background: Contrast-induced acute kidney injury (CI-AKI) is a sudden decline in kidney function within 24 to 72 hours post-exposure to contrast media (Andreucci et al., 2014). A spike in serum creatinine from prior to intervention of 25% or more with no other cause post a procedure involving contrast will indicate CI-AKI (Stacul et al., 2011). CI-AKI does not existing treatment therefore hydration prophylaxis is performed (Nijssen et al., 2020). In addition to prolonging hospital stay, mortality rate increases in patients with pre-existing comorbidities, therefore clinicians need act accordingly. The objective of this dissertation is to determine the efficacy of RenalGuard system (PLC Medical Systems, Inc., Franklin, MA) compared to standard hydration in patients diagnosed with heart failure. Research Question: In heart failure patients undergoing cardiac procedures, is RenalGuard more effective than intravenous hydration in preventing contrast-induced kidney injury? PICO Elements: (P)Population – patients diagnosed with heart failure who underwent cardiac procedures involving contrast. (I)Intervention was RenalGuard machine and the comparison (C) was standard hydration prophylaxis. (O)Outcome was low incidence of CI-AKI and pulmonary oedema. Inclusion and Exclusion Criteria: Patients due for elective cardiac interventional procedures, above the age of eighteen. Patients diagnosed with heart failure, Left Ventricular Ejection Fraction Rate (LVEF) less than 30,kidney disease from mild to chronic, hypertension and diabetes were included. Patients excluded were diagnosed with severe heart failure, pregnant, eGFR less than 30 mL/min/1.73m2 or serum creatinine less than 2.5mg/dL, patients who were recipients of renal transplant. Patients who had poor blood perfusion and diagnosed with acute STEMI. Outcome in search: Inclusion and exclusion criteria led to a selection of five articles that were satisfactory with the study. The study includes a meta-analysis, a systematic review, two randomised trials and one case-control study. Method: PICO elements and alternative keywords/synonyms were used. Use of synonyms/alternative keywords, truncation symbols and Boolean operators were included in the search. Databases such as HyDi, Medline, CINAHL, PubMed, Scopus and ProQuest Central were included. PRISMA checklist with the use of inclusion and exclusion criteria removed articles that were not applicable to the research question. CASP tool was used in literature appraisal of the final articles. Results: Five studies were selected, which comprised of a meta-analysis, a systematic review, two randomised control trials and a case-control study. The meta-analysis and systematic reviews showed more statistical results with relation CI-AKI. Conclusion: RenalGuard showed impact in reducing the incidence of CI-AKI in hospitalised patients. More studies are required to support the effectiveness of the RenalGuard. Implications and Recommendations: Hydration prophylaxis is important in reducing incidence of CI-AKI. Assessment of baseline blood values are important in determining the state of kidneys to determine the right intervention. A wide variety of intravenous fluids were included in various studies therefore the choice of intravenous fluids were according to the judgement of the clinician. More studies need to confirm which fluids are best including which diuretics and drugs could improve the intervention.
Description: B.Sc. (Hons)(Melit.)
URI: https://www.um.edu.mt/library/oar/handle/123456789/109897
Appears in Collections:Dissertations - FacHSc - 2022
Dissertations - FacHScNur - 2022

Files in This Item:
File Description SizeFormat 
22BSNR31 Chivhanganye Michelle Ruvarashe.pdf
  Restricted Access
987.39 kBAdobe PDFView/Open Request a copy


Items in OAR@UM are protected by copyright, with all rights reserved, unless otherwise indicated.