#3538 SURVIVAL OUTCOMES FOLLOWING CARDIOPULMONARY RESUSCITATION IN ADULTS RECEIVING KIDNEY REPLACEMENT THERAPY: A SYSTEMATIC REVIEW AND NARRATIVE SYNTHESIS

Abstract

Abstract Background and Aims Individuals receiving kidney replacement therapy (KRT) are at higher risk of cardiac arrest than the general population. The aim of this systematic review was to evaluate survival outcomes in individuals on different forms of KRT (haemodialysis, peritoneal dialysis or kidney transplantation) following cardiopulmonary resuscitation (CPR) within healthcare settings (hospital or outpatient clinics). Method A comprehensive literature search of EMBASE, MEDLINE, CINAHL, Web of Science and Central was carried using a pre-defined search strategy with no date or language restrictions. Retrospective and prospective observational studies reporting outcomes following CPR in adults on kidney replacement therapy were included. The study protocol was prospectively registered on PROSPERO: CRD42022336363. Results Thirteen eligible studies were identified. Due to the heterogeneity of study populations, lack of a standardised outcome set and inconsistent use of control groups, a narrative review was conducted, and a meta-analysis was not performed. Crude unadjusted survival rate to discharge from hospital was reported in 11 studies and ranged from 0%—75%. Only two studies reported neurological outcome at discharge, with rates of a favourable cerebral performance category score (CPC 1 or 2) on discharge between 17–20%. Conclusion The current evidence is insufficient to guide clinical decision-making regarding resuscitation due to a lack of up-to-date data, uncertainty about outcomes and inconsistent reporting of neurological status after CPR. Additionally, there is a lack of data comparing survival outcomes for people on different types of KRT. There remain unanswered questions regarding the likelihood of favourable outcomes for the KRT population and whether these can be accurately predicted using clinical and demographic features.