Thiamin supplementation on mitigating kidney injury and mortality in patients with septic shock: A systematic review and meta‐analysis of randomized controlled trials

BACKGROUND: The effectiveness of thiamin supplementation in mitigating renal injury and mortality outcomes in patients with septic shock remains uncertain. This systematic review and meta-analysis aimed to determine the efficacy of thiamin in patients with septic shock. MATERIALS AND METHODS: A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of septic shock with thiamin, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs) and weighted mean differences, with 95% confidence intervals (CIs). Six RCTs (enrolling 438 patients) met the inclusion criteria. RESULTS: Thiamin showed significant effects on in-hospital mortality (RR 0.80, 95% CI 0.65-0.99; P = 0.04) and renal replacement therapy (RR 0.48, 95% CI 0.31-0.74; P = 0.0009). CONCLUSION: Thiamin was associated with a reduction in in-hospital mortality and the use of renal replacement therapy in patients with septic shock. Thiamin should be considered for patients with septic shock.