Aminophylline for improving acute kidney injury in pediatric patients: A systematic review and meta-analysis

Saad Alsaadoun, Faisal Rustom, Hanan Abu Hassan, Hassan Alkhurais, Majed Aloufi, Saeed Alzahrani, Shireen Bakhsh, Sultan Al Dalbhi, Saad Alsaadoun, Faisal Rustom, Hanan Abu Hassan, Hassan Alkhurais, Majed Aloufi, Saeed Alzahrani, Shireen Bakhsh, Sultan Al Dalbhi

Abstract

Objectives: Acute kidney injury (AKI) is a major cause of morbidity and mortality. Whether aminophylline administration can prevent or treat AKI among pediatric patients are not clear. This meta-analysis aimed to assess the efficacy and effectiveness of aminophylline for pediatric AKI.

Methods: We carried out a systematic search of six databases: PubMed, EMBASE/Excerpta Medica, Scopus, Cochrane library, and Google Scholar from January 1995 up till May 2019. Summary measures of risk ratios and standard mean difference were calculated using the random effects model.

Results: We identified seven papers containing data on aminophylline use in children with AKI. Meta-analysis of single-arm studies indicated no statistically significant difference in mean rate of serum creatinine clearance (-0.39 [-0.80-1.58], P = 0.52), mean urine output (1.99 [-1.43-5.42]; P = 0.25), or mean blood urea nitrogen levels (0.83 [-1.86-3.03], P = 0.54) before and after aminophylline administration. However, among double-arm studies, aminophylline administration in the intervention arm significantly reduced the serum creatinine level as compared to control arm (mean diff = -34 [-55.18--12.83]; P = 0.002). Mean urine output (-112.68 [-27.43-48.9], P = 0.17), incidence of AKI (RR = 1.05 [0.80-1.37], P = 0.72), and mortality rates (RR = 0.79 [0.42-1.47], P = 0.45) were found to be statistically insignificant.

Conclusions: Aminophylline administration in children with AKI reduces serum creatinine level without significant adverse effects or effect on the incidence of AKI, urine output, or mortality. Further, large-scale well-planned randomized controlled trials are needed to evaluate its use and its potential long-term effects.

Keywords: Aminophylline; acute kidney injury; efficacy; pediatric patients; renal outcomes.

Copyright: © International Journal of Health Sciences.

Figures

Figure 1
Figure 1
Flowchart showing selection of studies
Figure 2
Figure 2
Forest plot comparing serum creatinine clearance rate before and after aminophylline administration among pediatric patients
Figure 3
Figure 3
Forest plot comparing urine output rate before and after aminophylline administration among pediatric patients
Figure 4
Figure 4
Forest plot comparing mean BUN clearance levels before and after aminophylline administration among pediatric patients
Figure 5
Figure 5
Forest plot comparing change in serum creatinine concentration among aminophylline administration group versus control group among pediatric patients
Figure 6
Figure 6
Forest plot comparing mean urinary output among aminophylline administration group versus control group among pediatric patients
Figure 7
Figure 7
Forest plot comparing acute kidney injury among aminophylline administration group versus control group among pediatric patients
Figure 8
Figure 8
Forest plot comparing mortality rate among aminophylline administration group versus control group among pediatric patients

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Source: PubMed

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