Acute kidney injury after robot-assisted laparoscopic prostatectomy: A meta-analysis.

BACKGROUND: We investigated the rates of acute kidney injury (AKI) post robot-assisted laparoscopic prostatectomy (RALP). METHODS: A comprehensive search was conducted to identify studies that reported the rates of AKI post-RALP. A random effects model was used, and the pooled rates of AKI were calculated. RESULTS: We identified 10 studies with 60,937 patients to be included. The mean age was 65.1 years. The mean anaesthesia time was 234.3 min (95% CI: 177.8-290.9). The mean operation time was 212.2 min (95% CI: 188.7-235.6). The mean estimated blood loss was 314.1 mL (95% CI: 153-475.3). The mean intraoperative IV fluids administered were 1985 mL (95% CI: 1516.3-2453.7). The pooled rate of AKI post RALP was 7.2% (95% CI 19-23.9). CONCLUSIONS: The rates of AKI after RALP are significant. Further studies are needed to detect the risk factors for AKI and to determine the rates of chronic kidney disease post-RALP.

Glycated Haemoglobin (HbA1c) Variations in Nondiabetics With Nutritional Anemia.

OBJECTIVES: Diabetes is prevalent in the Indian population, to the extent that the diabetes burden matches that of nutritional anemia. We aimed to determine the effects of iron and vitamin B12 deficiency anemia on glycated haemoglobin (HbA1c) concentrations in individuals without diabetes. MATERIAL AND METHODS: The study comprises 100 patients with iron deficiency anemia, 100 with vitamin B12 deficiency anemia, and 100 healthy volunteers as a control group. Each of the first two groups was subdivided into two groups depending on the severity of anemia based on Hb levels. We treated with iron replenishment in the iron deficiency group and B12 replenishment in the B12 deficiency group for three months. We noted HbA1c levels before and after the therapy. Data were entered into the SPSS package. For comparing pre and post-therapy levels, we used the Paired 't' test. RESULTS: The mean HbA1c before treatment were 6.1% ± 0.23% and 5.5% ± 0.24%, and the values after treatment were 5.1% ± 0.14% and 4.6% ± 0.2% in severe iron deficiency anemia subgroup and mild to moderate subgroup, respectively. The mean HbA1c in the iron-deficiency anemia control group was 5.2% ± 0.2%. The mean HbA1c levels before treatment were 5.9% ± 0.3% and 5.6% ± 0.19%, and after treatment were 5.0% ± 0.15% and 4.9% ± 0.16% in severe and mild to moderate B12 deficiency anemia, respectively. The mean HbA1c in the vitamin B12 deficiency anemia control group was 5.1% ± 0.2%. CONCLUSION: HbA1c in both types of anemia subjects showed a significant decrease with appropriate therapy. Physicians should consider rechecking patient haemoglobin values and correcting a patient's anemia before determining the patient's glycemic status using HbA1c to avoid misinterpretation of their diabetes status.