Abstract
Introduction:
Urine alkalinization can reduce the toxic effects of myoglobin on renal tubules, but the effects of alkaline hydration on the outcomes of rhabdomyolysis patients are unclear. This systematic review and meta-analysis aimed to determine the role of alkalinization in preventing rhabdomyolysis-induced acute kidney injury (AKI) and the need for dialysis.
Methods
We conducted a systematic review and meta-analysis following the PRISMA guideline. We searched for relevant articles in multiple databases, removed duplicates, and screened the remaining articles based on title, abstract, and study criteria. Two researchers independently assessed the remaining studies by reading the full text, and any discrepancies were resolved through discussion. We used the ROBINS-I tool to assess the risk of bias and excluded studies with a critical risk of bias from the final analysis.
Results
Out of 9230 initially identified articles, 5 studies met the inclusion criteria to be entered in the meta-analysis. The meta-analysis revealed no significant effectiveness of urine alkalinization in preventing AKI (OR: 2.11 (95% CI: 0.09–47.72), p value: 0.3) or acute renal failure development (OR: 1.26 (95% CI: 0.86–1.84), p value = 0.36) or reducing the need for dialysis (OR: 4.25 (95% CI: 0-3.8e+ 07), p value = 0.25) following rhabdomyolysis.
Conclusion
It seems that, addition of sodium bicarbonate to fluid therapy solution does not significantly protect against AKI, dialysis need, or acute renal failure in rhabdomyolysis patients. Further insight can be gained through conducting controlled randomized clinical trials.