Meta-analysis of haematocrit and activated partial thromboplastin time as risk factors for unplanned interruptions in patients undergoing continuous renal replacement therapy

Abstract

Objective: Although continuous renal replacement therapy (CRRT) is common, unplanned interruptions often limit its usefulness. Unplanned interruption refers to the forced interruption of blood purification treatment, the failure to complete blood purification treatment goals or the failure to meet blood purification schedule times. This study aimed to evaluate the effect of haematocrit and activated partial thromboplastin time (APTT) on the incidence of unplanned interruptions in critical patients with CRRT. Methods: A systematic review and a meta-analysis were performed by searching the databases of China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Literature, Cochrane Library, PubMed, Web of Science and Embase from their inception to 31st March 2022 for all studies with a comparator or independent variable relating to the unplanned interruption of CRRT. Results: Nine studies involving 1165 participants were included. Haematocrit and APTT were independent risk factors for the unplanned interruption of CRRT. The higher the haematocrit level, the greater the risk of unplanned CRRT interruptions (relative risk ratio [RR] = 1.04, 95% confidence interval [CI]: 1.02, 1.07, Z = 4.27, p < 0.001). The prolongation of APPT reduced the risk of unplanned CRRT interruptions (RR = 0.94, 95% CI: 0.92, 0.96, Z = 6.10, p < 0.001). Conclusion: Haematocrit and APTT are the influencing factors on the incidence of unplanned interruptions in critical patients undergoing CRRT.