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Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials

Overview of attention for article published in Critical Care, December 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Citations

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Title
Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0880-2
Pubmed ID
Authors

Sheng-Yuan Ruan, Tao-Min Huang, Hon-Yen Wu, Huey-Dong Wu, Chong-Jen Yu, Mei-Shu Lai

Abstract

Inhaled nitric oxide (iNO) is an important therapy for acute respiratory distress syndrome (ARDS), pulmonary hypertension and pediatric hypoxemic respiratory failure. Safety concerns regarding iNO and renal dysfunction have been reported; however, there are currently no systematic reviews on this issue. Our objective was to evaluate published randomized controlled trials (RCTs) to ascertain the risk of renal dysfunction associated with iNO therapy in patients with and without ARDS. A systematic review of databases was performed to identify RCTs which compared iNO with controls up to September 2014. Effect estimates for risk ratio (RR) of acute kidney injury (AKI) were pooled using a random-effects model. Ten RCTs involving 1363 participants were included. Inhaled nitric oxide significantly increased the risk of AKI compared with controls (RR, 1.4, 95%CI, 1.06 to 1.83, p = 0.02). In the stratified analysis, a high cumulative-dose of iNO significantly increased the risk of AKI (RR, 1.52, 95%CI, 1.14 to 2.02, p = 0.004), whereas medium and low cumulative-doses did not (RR, 0.64, 95%CI, 0.23 to 1.81 and RR, 0.56, 95%CI, 0.11 to 2.86 respectively). In subgroup analysis by study population, an increased risk of AKI was observed in patients with ARDS (RR, 1.55, 95%CI, 1.15 to 2.09, p = 0.005) but not in those without (RR, 0.90, 95%CI, 0.49 to 1.67, p = 0.75). The available data show that iNO therapy may increase the risk of renal dysfunction, especially with prolonged use and in patients with ARDS. The risk in pediatric population is unknown owing to limited data. We suggest monitoring renal function during iNO therapy, and that future trials of iNO should evaluate renal safety.

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Mendeley readers

The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 3%
Mexico 1 1%
Japan 1 1%
Greece 1 1%
United States 1 1%
Unknown 68 92%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 14%
Student > Master 10 14%
Student > Postgraduate 9 12%
Other 7 9%
Student > Ph. D. Student 7 9%
Other 22 30%
Unknown 9 12%
Readers by discipline Count As %
Medicine and Dentistry 47 64%
Nursing and Health Professions 4 5%
Agricultural and Biological Sciences 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 4%
Biochemistry, Genetics and Molecular Biology 2 3%
Other 5 7%
Unknown 10 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 May 2020.
All research outputs
#1,905,040
of 21,358,386 outputs
Outputs from Critical Care
#1,711
of 5,807 outputs
Outputs of similar age
#26,542
of 240,386 outputs
Outputs of similar age from Critical Care
#1
of 32 outputs
Altmetric has tracked 21,358,386 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,807 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.6. This one has gotten more attention than average, scoring higher than 70% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 240,386 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.