Abstract
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the efficacy of urine alkalinization in preventing acute kidney injury (AKI) and the need for dialysis in patients with rhabdomyolysis. METHODS: This study was conducted in accordance with the PRISMA guideline. A systematic literature search of MEDLINE/ PubMed, Scopus, Web of Science, and Embase databases was conducted. No time or language restrictions were applied to maximize the scope of the results. After removing duplicates, the remaining articles were screened by title, abstract, and study criteria. Two researchers independently assessed the full texts of the remaining studies, with any discrepancies resolved through discussion. The risk of bias was assessed using the ROBINS-I tool, and studies with a critical risk of bias were excluded from the final analysis. RESULTS: Out of 9,230 initially identified articles, five studies met the inclusion criteria for the meta-analysis. The analysis revealed that urine alkalinization was not significantly effective in preventing AKI (OR: 2.11; 95% CI: 0.09-47.72; p=0.3), preventing acute renal failure (OR: 1.26; 95% CI: 0.86-1.84; p=0.36), or reducing the need for dialysis (OR: 4.25; 95% CI: 0-3.8e(+07); p=0.25). CONCLUSION: The addition of sodium bicarbonate to fluid therapy solution did not appear to provide significant protection against AKI, acute renal failure, or the need for dialysis in patients with rhabdomyolysis. Further insight should be sought through controlled randomized clinical trials with larger sample sizes.