A Systematic Review and Meta-analysis of Nonpharmacologic-based Interventions for Aortic Stiffness in End-Stage Renal Disease.

aortic stiffness end-stage renal disease pulse wave velocity renal dialysis renal transplantation vascular stiffness

Journal

Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 23 01 2019
revised: 08 04 2019
accepted: 13 05 2019
entrez: 24 8 2019
pubmed: 24 8 2019
medline: 24 8 2019
Statut: epublish

Résumé

Increased carotid-femoral pulse wave velocity (cf-PWV) in end-stage renal disease (ESRD) indicates enhanced aortic stiffness and mortality risk. We conducted a systematic review and meta-analysis of nonpharmacologic interventions in adults with ESRD to determine their effects on cf-PWV, systolic blood pressure (SBP), and intervention-associated adverse events. MEDLINE, EMBASE, and EBM databases were searched. Study screening, selection, data collection, and methodological quality assessments were performed by 2 independent reviewers. Pooled-effect estimates from mean differences and 95% confidence intervals (CIs) were calculated using random effect models. A total of 2166 subjects with ESRD from 33 studies (17 randomized; 16 nonrandomized) were included. Four intervention-comparator pairs were meta-analyzed. Quality of evidence ranged from very low to moderate. Kidney transplantation decreased cf-PWV (-0.70 m/s; CI: -1.3 to -0.11; Several nonpharmacologic interventions effectively decrease aortic stiffness in ESRD. The impact of these interventions on cardiovascular outcomes and mortality risk reduction in ESRD requires further study.

Identifiants

pubmed: 31440701
doi: 10.1016/j.ekir.2019.05.011
pii: S2468-0249(19)30206-2
pmc: PMC6698308
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1109-1121

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Auteurs

Rosendo A Rodriguez (RA)

Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.

Richard Hae (R)

Division of Nephrology, Kidney Research Centre, University of Ottawa, Ottawa, Ontario, Canada.

Matthew Spence (M)

Division of Nephrology, Kidney Research Centre, University of Ottawa, Ottawa, Ontario, Canada.

Beverley Shea (B)

Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Mohsen Agharazii (M)

CHU de Québec Research Centre, Québec, QC, Canada.

Kevin D Burns (KD)

Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.
Division of Nephrology, Kidney Research Centre, University of Ottawa, Ottawa, Ontario, Canada.
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Classifications MeSH