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Informative for Decision Making? The Spectrum and Consistency of Outcomes After Living Kidney Donation Reported in Trials and Observational Studies

机译:做出乐言的决策? 在审判和观察研究中患有肾脏捐赠后的结果的谱和一致性

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Background. Evidence about outcomes after living kidney donation is needed both to inform donor acceptance criteria, and to guide the decisions of potential donors and their healthcare providers about donation. However, the scope and heterogeneity of outcomes reported in research and their relevance to decision making is uncertain. To determine the spectrum and consistency of outcomes reported in randomized trials and observational studies in living kidney donors 18 years or older. Methods. Electronic databases were searched for randomized trials and observational studies reporting outcomes in adult living kidney donors published from January 2011 to May 2017. All outcome domains and measurements were extracted, and their frequency and characteristics were evaluated. Results. Of the 268 eligible studies, 14 (5%) were randomized and 254 (95%) observational. Overall, 136 (51%) studies were short-term (= 1 year follow up) and reported 109 outcome domains, of which 51 (47%) were classified as clinical, 35 (32%) were surrogate, and 23 (21%) were donor-reported. The 5 most commonly reported domains were kidney function (154, 58%), time to discharge (96, 36%), blood loss (85, 32%), operative time (79, 30%) and blood pressure (74, 28%). Quality of life (13%), mortality (16%), end-stage kidney disease (10%) and cardiovascular events (9%) were reported infrequently. Conclusions. The outcomes of living kidney donation reported in contemporary trials and observational studies are numerous, heterogeneous, and often focused on short-term surgical complications. Consistent reporting of outcomes relevant to decision making is needed to better inform and prepare donors for outcomes after donation.
机译:背景。关于生活捐肾后的结局证据都需要告知捐助验收标准,并引导潜在的捐赠者和捐赠左右他们的医疗保健提供者的决定。然而,范围和结果的异质性报道的研究及其对决策的相关性是不确定的。为了确定随机试验和活体供肾者18岁或以上的观察性研究报告结果的频谱和一致性。方法。电子数据库,查找随机试验和观察性研究报告发表在从2011年1月2017年5所有结果域和测量提取成人间活体肾移植供结果,以及其频率和特性进行了评价。结果。 268项合格研究中,14(5%),随机和254(95%)观察。总体上,136(51%)的研究是短期的(小于= 1年的随访),并报告109个的结果域,其中51(47%)的被归类为临床,35(32%)为替代,和23( 21%)为供体的报道。 5个最常见的结构域是肾功能(154,58%),时间放电(96,36%),失血(85,32%),手术时间(79,30%)和血压(74,28 %)。生活(13%),死亡率(16%),终末期肾病(10%)和心血管事件(9%)的质量都很少报道。结论。生活在当代的试验和观察性研究报告捐肾的结果是大量的,异构的,而且往往集中在短期的手术并发症。需要有关决策结果的报告一致献血后的成果,更好地宣传和准备捐助者。

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