The Application Value of CRRT in the Treatment of Cardio-Renal Syndrome: A Meta Analysis

Objective: To evaluate the therapeutic effect of continuous renal replacement therapy (CRRT) combined with drug therapy and drug therapy alone on cardiorenal syndrome (CRS) by statistically comparing the efficacy of CRRT in the clinical treatment of CRS. Method: Chinese databases (China National Knowledge Infrastructure, VIP Database, Wanfang Database) and English databases (PubMed, EmBase, The Cochrane Library, Web of Science) were searched for literature on continuous renal replacement therapy (CRRT) and the application of conventional drugs in cardiorenal syndrome (CRS) using computers. The search period was from the establishment of each database to September 1, 2023. By reading and screening the title, abstract, and full text, 10 articles that meet the inclusion criteria were finally included. Excel was used to summarize and integrate the data, and RevMan5.3 software was used for outcome indicator analysis. Result: A total of 10 articles were included. Including 741 patients, including 369 patients in the continuous renal replacement therapy (CRRT) combined with drug treatment group and 372 patients in the internal medicine drug treatment group. 1. Cr: The decrease in CRRT group was higher than that in the internal medicine drug treatment group[MD=-58.73, 95%CI(-108.77, -8.69),P=0.02], (I²=98%, P＜0.00001); 2. LVEF: The recovery of the CRRT group was better than that of the internal medicine drug treatment group [MD=5.93,95%CI(3.21, 8.65),P＜0.0001],(I²=85%,P＜0.00001); 3. BUN: The CRRT group showed better reduction than the internal medicine drug treatment group[MD=-1.21, 95%CI(-1.75, -0.67), P＜0.0001], (I²=93%, P＜0.00001); 4. UA: The decrease in CRRT group was higher than that in the internal medicine drug treatment group[MD=-95.05, 95%CI(-156.94, -33.16), P=0.003], (I²=80%, P=0.002); 5. BNP: The reduction effect of CRRT group is better than that of internal medicine drug treatment group[MD=-474.92, 95%CI(-636.76, -313.09), P＜0.00001], (I²=91%,P＜0.00001); 6. LVD: The CRRT group showed better reduction than the internal medicine drug treatment group[MD=-3.97, 95%CI(-6.75, -1.19), P=0.005], (I²=0%, P=0.002); 7. Urine output: The CRRT group showed better recovery than the internal medicine drug treatment group[MD=87.91, 95%CI(38.09, 137.73), P=0.0005], (I²=84%, P=0.002); 8. Classification of cardiac function: The downgrading effect of the CRRT group is better than that of the internal medicine drug treatment group[MD=-1.10, 95%CI(-1.43, -0.78), P＜0.00001], (I²=76%, P=0.02); 9. GFR: The increase in CRRT group was better than that in the internal medicine drug treatment group[MD=21.36,95%CI(18.59, 24.13), P＜0.00001], (I²=0%, P=0.73); 10.Ccr:The recovery of the CRRT group was better than that of the internal medicine drug treatment group[MD=7.68,95%CI(4.52, 10.83)P＜0.00001](I²=82%, P=0.02); 11.SV: There was no statistically significant difference between the CRRT group and the internal medicine treatment group[MD=2.35, 95%CI(-3.38, 8.07), P=0.42], (I²=92%, P=0.0006); 12. CysC: There was no statistically significant difference between the CRRT group and the internal medicine treatment group[MD=-1.13, 95%CI(-2.41, 0.15), P=0.08], (I²=95%, P=0.00001); 13. K+: There was no statistically significant difference between the CRRT group and the internal medicine treatment group[MD=-0.15, 95%CI(-0.31, 0.01), P=0.07], (I²=0%, P=0.75).