scholarly journals Intensive systolic blood pressure control and incident chronic kidney disease in people with and without diabetes mellitus: secondary analyses of two randomised controlled trials

2018 ◽  
Vol 6 (7) ◽  
pp. 555-563 ◽  
Author(s):  
Srinivasan Beddhu ◽  
Tom Greene ◽  
Robert Boucher ◽  
William C Cushman ◽  
Guo Wei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomised Controlled Trials ◽  
Pressure Control ◽  
Controlled Trials ◽  
Incident Chronic Kidney Disease ◽  
Secondary Analyses ◽  
Randomised Controlled

Telehealth for the management of blood pressure in patients with chronic kidney disease: A systematic review

2017 ◽  
Vol 25 (2) ◽  
pp. 80-92 ◽  
Author(s):  
Li Luo ◽  
Meiqin Ye ◽  
Jiaowang Tan ◽  
Qiong Huang ◽  
Xindong Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Randomised Controlled

Background Most patients with chronic kidney disease (CKD) fail to achieve blood pressure (BP) management as recommended. Meanwhile, the effects of promising intervention and telehealth on BP control in CKD patients remain unclear. We aimed to evaluate the efficacy of telehealth for BP in CKD non-dialysis patients. Methods Databases including MEDLINE, EMBASE, CENTRAL, CNKI, Wanfang, VIP and CBM were systematically searched for randomised controlled trials or quasi-randomised controlled trials on telehealth for BP control of CKD3-5 non-dialysis patients. We analysed systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), serum creatinine, and estimated glomerular filtration rate (eGFR) with a fixed-effects model. Results Three studies, with total 680 subjects, were included in our systematic review and two were included for meta-analysis. Pooled estimates showed decreased SBP (pooled mean difference (MD), −5.10; 95% confidence interval (CI), −11.34, 1.14; p > 0.05, p = 0.11), increased DBP (pooled MD, 0.45; 95% CI, −4.24, 5.13; p > 0.05, p = 0.85), decreased serum creatinine (pooled MD, −0.38; 95% CI, −0.83, 0.07; p > 0.05, p = 0.10) and maintained eGFR (pooled MD, 4.72; 95% CI, −1.85, 11.29; p > 0.05, p = 0.16) in the telehealth group. There was no significant difference from the control group. MAP (MD, 0.6; 95% CI, −6.61, 7.81; p > 0.05, p = 0.87) and BP control rate ( p > 0.05, p = 0.8), respectively, shown in two studies also demonstrated no statistical significance in the telehealth group. Conclusions There was no statistically significant evidence to support the superiority of telehealth for BP management in CKD patients. This suggests further studies with improved study design and optimised intervention are needed in the future.

scholarly journals Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials

BMJ ◽  
2008 ◽  
Vol 336 (7645) ◽  
pp. 645-651 ◽  
Author(s):  
Giovanni F M Strippoli ◽  
Sankar D Navaneethan ◽  
David W Johnson ◽  
Vlado Perkovic ◽  
Fabio Pellegrini ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Meta Regression ◽  
Randomised Controlled

scholarly journals Oral Bicarbonate Therapy in Non-Haemodialysis Dependent Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2019 ◽  
Vol 8 (2) ◽  
pp. 208 ◽  
Author(s):  
May Khei Hu ◽  
Miles D. Witham ◽  
Roy L. Soiza
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Metabolic Acidosis ◽  
Kidney Disease ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Controlled Trials ◽  
Bicarbonate Therapy ◽  
Randomised Controlled

Metabolic acidosis is a common complication in chronic kidney disease (CKD) patients, and is associated with an accelerated decline in renal function. Oral bicarbonate therapy has been used to counteract metabolic acidosis in CKD for decades. However, until recently, there have been very few intervention studies testing the effectiveness of bicarbonate therapy at improving metabolic acidosis or its consequences in patients with CKD. In this systematic review and meta-analysis, we aimed to examine the outcomes of all published randomised controlled trials (RCTs) that investigated the effect of oral bicarbonate therapy in adults with CKD. Ovid MEDLINE®, EMBASE® and Cochrane Library were searched in mid-October 2018 for English literature, with no restrictions applied to the publication status or date. Seven RCTs that recruited 815 participants met our inclusion criteria after full text review. Oral bicarbonate supplementation resulted in a slightly higher estimated glomerular filtration rate (eGFR) (mean difference 3.1 mL/min per 1.73 m2; 95% CI 1.3–4.9) and serum bicarbonate levels (mean difference 3.4 mmol/L; 95% CI 1.9–4.9) at the end of follow-up (three months to five years) compared to those given placebo or conventional CKD treatment. When limited to studies reporting outcomes at one year, the positive effect of oral bicarbonate therapy on eGFR was attenuated. There were no significant treatment effects in other parameters such as systolic blood pressure (BP) and weight. These findings should be interpreted with caution and further trial evidence is needed to establish the net overall benefit or harm of oral bicarbonate therapy in CKD.

scholarly journals The risk of non-steroidal anti-inflammatory drug-induced heart failure in people with chronic kidney disease: a systematic review

2021 ◽  
Author(s):  
Bethany S. Ward ◽  
Michael Naughton ◽  
Dorothea Nitsch ◽  
Mariam Molokhia
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomised Controlled Trials ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Drug Induced ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Randomised Controlled

Abstract Aim To examine the risk of non-steroidal anti-inflammatory drug-induced heart failure in patients with chronic kidney disease. Methods Embase, Medline, CENTRAL, Web of Science, and Google Scholar were searched for papers published in English between 1st January 1999 and 31st May 2020. Papers were included if some participants had chronic kidney disease, were exposed to non-steroidal anti-inflammatory drugs, and where heart failure was measured as an outcome. Papers were assessed for risk of bias using the Cochrane Risk of Bias 2 tool for randomised controlled trials, and ROBINS-I for observational studies. Results A total of 2480 independent papers were retrieved. Following abstract screening, 165 full texts were reviewed to identify seven eligible papers: two randomised controlled trials, four cohort studies, and one case-control study. For chronic kidney disease (stage 3–5), relative risk for heart failure ranged from 0.3 to 1.9 with 95% confidence interval 0.04 to 15.1. Results were not pooled due to study heterogeneity. We attributed bias to heterogenous populations studied, probable confounding due to partially adjusted risk estimates, and heterogenous measurement of the heart failure outcome. Conclusion Overall, there are only a few studies to refute or support an increased risk of heart failure associated with taking non-steroidal anti-inflammatory drugs in patients with chronic kidney disease, and therefore no robust evidence was available.

scholarly journals Kidney Disease: Improving Global Outcomes (KDIGO) New Guideline for Diabetes Management in Chronic Kidney Disease: A Meet-the-Expert Session

EMJ Diabetes ◽  
2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetes Management ◽  
Pressure Control ◽  
Sufficient Evidence ◽  
Lipid Management ◽  
Patients With Diabetes ◽  
New Guidelines ◽  
Randomised Controlled

Prof de Boer opened this virtual seminar on the new Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on diabetes management in chronic kidney disease (CKD), which is the first set of KDIGO guidance on this topic. Prof de Boer emphasised that the aim of the guideline was to generate a useful resource for clinicians and patients, to address relevant questions with actionable recommendations supplemented by practice points, to take on controversial topics when sufficient evidence was available, and to communicate findings clearly and concisely. The scope of the new guideline includes patients with Type 1 diabetes mellitus, Type 2 diabetes mellitus, and all severities of CKD, including patients treated with dialysis or kidney transplantation. The new guideline also includes recommendations related to lifestyle, pharmacotherapy, and the organisation of healthcare systems, addressed using systematically identified data from randomised controlled trials. Topics such as blood pressure control and lipid management and prevention of and screening for diabetes are not covered by the new KDIGO guideline and have been addressed either in prior KDIGO publications or in other international guidelines. After his introduction, Prof de Boer handed over to Prof Rossing, who offered a detailed overview of the new guidelines, and Ms Sadusky, who highlighted the contribution of patients in the development of the guidelines. Prof Rossing and Ms Sadusky concluded the seminar by emphasising the importance of shared decision-making, where the patient is involved in defining individualised treatment goals, and the critical need for a team-based approach in the care of patients with diabetes and CKD.

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