scholarly journals Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998–2019

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Ling Liu ◽  
Yanqiu Wang ◽  
Wanjun Zhang ◽  
Weiwei Chang ◽  
Yuelong Jin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Cochrane Library ◽  
Height Ratio ◽  
Physical Measurements ◽  
Significant Difference ◽  
The Difference

Abstract Background The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. Methods Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. Results Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. Conclusion WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.

Therapeutic targets for the anemia of predialysis chronic kidney disease: a meta-analysis of randomized, controlled trials

2019 ◽  
Vol 67 (6) ◽  
pp. 1002-1008 ◽  
Author(s):  
Hongyong Liu ◽  
Yuqiu Ye ◽  
Yanbing Chen ◽  
Yunqiang Zhang ◽  
Shaomin Li ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Prognostic Impact ◽  
Stroke Treatment ◽  
Risk Of Death ◽  
Mesh Terms ◽  
Significant Difference ◽  
All Cause Mortality

Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. This article aims to establish the suitable hemoglobin target to provide clinical guidance. MEDLINE, EmBase, the Cochrane Library and other databases were searched with both MeSH terms and keywords to gather researches that assessed all-cause mortality, stroke, treatment of renal replacement, and transfusion. The meta-analysis was accomplished via Revman 5.3 version. Totally, 13 eligible studies involving 7606 patients were included. There was a significantly lower risk of transfusion (risk ratio (RR) 0.59, 95% CI 0.52 to 0.67; p<0.00001) in the higher hemoglobin group than in the lower one. However, no significant difference was found in all-cause mortality (RR 1.10, 95% CI 0.98 to 1.23; p=0.11), stroke (RR 1.32, 95% CI 0.82 to 2.10; p=0.25) and treatment of renal replacement including hemodialysis, peritoneal dialysis and renal transplant (RR 1.08, 95% CI 0.95 to 1.22; p= 0.23) between the higher hemoglobin group and the lower one. The results favor the higher hemoglobin target. To target the higher hemoglobin when treating predialysis patients with CKD may decrease the risk of transfusion without increasing the risk of death, stoke, and treatment of renal replacement.

MO740EFFECT OF DIPHOSPHONATES FOR VASCULAR CALCIFICATION IN CHRONIC KIDNEY DISEASE: A META-ANALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Canlin Yang ◽  
Xiaotong Xie ◽  
Jie Xing ◽  
Xin Yang ◽  
Xiao liang Zhang
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Serum Parathyroid Hormone ◽  
Blood Calcium ◽  
Significant Difference

Abstract Background and Aims Vascular calcification is an independent predict factor of cardiovascular mortality and all-cause mortality in chronic kidney disease (CKD) patients. Animals experiments and clinical studies showed the inhibition effect of diphosphonates in vascular calcification, but the results of the studies remains controversial. This meta-analysis aims to evaluate the effects of diphosphonates on vascular calcification in patients with CKD. Method Randomized controlled trials (RCT) and non-RCTs of diphosphonates for the treatment of vascular calcification in CKD patients until September 2020 were searched in the database of PubMed, Embase, Cochrane library, CNKI and Wanfang. Literatures were screened according to the inclusion and exclusion criteria and quality was evaluated by two investigators independently. The standard deviation from mean (SMD) and 95% confidence interval (CI) were used to representthe counting data. Data extracted from the literatures were analyzed with Stata software (version 15.0). Results A total of 6 RCTs and 1 non-RCT with 272 patients were included, characteristics of the studies included are shown in Table 1. Meta-analysis indicated that diphosphonates inhibit vascular calcification in CKD [SMD =-0.297, 95% CI = (-0.591, -0.002), P = 0.049] (Figure 1). Etidronate is the most effective one in treating with vascular calcification (P = 0.020) (Figure 2). But there isn’t significant difference in aortic artery calcification and coronary artery calcification compared with the control group (P&gt;0.05). There was no statistically significant difference in the change of blood calcium, blood phosphate, and serum parathyroid hormone between two groups (all P&gt;0.05). Conclusion Diphosphonates can inhibit the progression of vascular calcification in CKD patients, and it hasn’t obvious effect on blood calcium, blood phosphate, and serum parathyroid hormone. Etidronate is the most promising therapeutic agent.

scholarly journals Efficacy and Safety of Tanshinone for Chronic Kidney Disease: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yao Zhou ◽  
Shi-min Jiang ◽  
Li Li ◽  
Ying Wang ◽  
Lei Ding ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Treatment Group ◽  
Kidney Disease ◽  
Subgroup Analysis ◽  
Protein Level ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Urine Protein

Objective. To systematically evaluate the efficacy and safety of tanshinone for chronic kidney disease (CKD). Methods. Randomized controlled trials (RCTs) on the treatment of CKD using tanshinone were searched using 4 Chinese databases (China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), Wanfang, and Chinese Biology Medicine (CBM)) and 3 English databases (PubMed, Cochrane Library, and Excerpta Medica Database (Embase)). The results included data on blood urine nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR), 24 h urine protein, microalbuminuria (mALB), β2-macroglobulin (β2-MG), cystatin C (CysC), and safety events. The data were analyzed using Revman 5.3 and Stata 12.0 software. Results. Twenty-one studies were entered into this meta-analysis, which involved 1857 patients including 954 cases from the tanshinone treatment group and 903 cases from the control group. BUN levels in the tanshinone treatment group were significantly reduced compared with the control (standardized mean difference (SMD) = −0.65, 95% confidence interval (CI): −0.81 to −0.49, p<0.01). In addition, subgroup analysis indicated that tanshinone had a significant effect in reducing Scr levels at 14, 21, and 28 days. Scr levels in the tanshinone treatment group were significantly reduced compared with the control group (SMD = −1.40, 95% CI: −2.09 to −0.71, p<0.01); subgroup analysis based on treatment time also yielded the same results. GFR in the tanshinone treatment group was better than that in the control group (SMD = 0.83, 95% CI: 0.59 to 1.07, p<0.01). In terms of urine protein levels, 24 h urine protein level, mALB, and β2-MG of CKD patients were reduced to some degree compared with controls, and CysC levels in the tanshinone treatment group were also significantly reduced compared with the control group (SMD = −0.24, 95% CI: −0.44 to −0.03, p<0.05). Safety in the tanshinone treatment group did not differ significantly from that of the control group (risk ratio (RR) = 7.78, 95% CI: 0.99 to 61.05, p>0.05). Conclusion. This meta-analysis showed that tanshinone could control urine protein level in CKD patients, improve kidney function, and delay the evolution of CKD without significant side effects. However, the results were limited and should be interpreted with caution because of the low quality of the included studies. In the future, more rigorous clinical trials need to be conducted to provide sufficient and accurate evidence.

scholarly journals DIFFERENCES OF SALIVA LEPTIN LEVELS IN CHILDREN WITH CHRONIC KIDNEY DISEASE ON HEMODIALYSIS AND HEALTHY CHILDREN (STUDY IN CHILDREN WITH GINGIVITIS)

2018 ◽  
Vol 11 (4) ◽  
pp. 192
Author(s):  
Berthauli Esther Nurmaida ◽  
Heriandi Sutadi ◽  
Sarworini B Budiardjo ◽  
Eka Laksmi Hidayati
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Immunosorbent Assay ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Children ◽  
Significant Difference ◽  
The Difference

 Objectives: Analyze the difference of salivary leptin in between healthy children with gingivitis and hemodialysis (HD) children with gingivitis.Methods: A total of 20 children, ages 11–16-year-old with gingivitis, were chosen as subjects; 10 were on HD and 10 were healthy children. The level of salivary leptin was measured using the enzyme-linked immunosorbent assay method.Results: The results showed a significant difference of salivary leptin levels between the children on HD (61,300 ± 4151 pg/ml) and the healthy children (57,200 ± 3173 pg/ml).Conclusions: There is a significant difference in the salivary leptin levels in children on HD with gingivitis and healthy children with gingivitis.

Urgent-start peritoneal dialysis in chronic kidney disease patients: A systematic review and meta-analysis compared with planned peritoneal dialysis and with urgent-start hemodialysis

2020 ◽  
pp. 089686082091871
Author(s):  
Guo Xieyi ◽  
Tang Xiaohong ◽  
Wu Xiaofang ◽  
Li Zi
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Exit Site Infection ◽  
Quality Of Evidence ◽  
Significant Difference

An increasing number of studies have focused on whether peritoneal dialysis (PD) can be used for the urgent initiation of dialysis in patients with chronic kidney disease (CKD). We performed this systematic review and meta-analysis to evaluate the feasibility and safety of urgent-start PD compared with those of planned PD and urgent-start hemodialysis (HD) in this population. PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), clinicaltrials.gov , and China National Knowledge Infrastructure (CNKI) were searched for relevant studies. Conference abstracts were also searched in relevant websites. The meta-analysis was performed using RevMan 5.3 software. A total of 15 trials involving 2426 participants were identified. The quality of the included studies was fair, but the quality of evidence was very low. Unadjusted meta-analysis showed that urgent-start PD had significantly higher mortality than planned PD, while adjusted meta-analysis did not show a significant difference. Higher incident of leakage and catheter mechanical dysfunction were observed in urgent-start PD. However, peritonitis, exit-site infection, or PD technique survival were comparable between urgent-start and planned PD. The all-cause mortality was comparable in urgent-start PD and urgent-start HD. Bacteremia was significantly lower in the urgent-start PD group than with urgent-start HD. Based on limited evidences, PD may be a viable alternative to HD for CKD patients requiring urgent-start dialysis. Because of the inconsistent results and the low quality of evidence, a definitive conclusion could not be drawn for whether urgent-start PD was comparable with planned PD. Therefore, high-quality and large-scale studies are needed in the future.

Comparison between Intravenous Iron and Oral Iron Preparations for the Treatment of Anemia of Chronic Kidney Disease - A Systematic Review and Meta-Analysis

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3748-3748
Author(s):  
Anat Gafter-Gvili ◽  
Benaya Rozen-Zvi ◽  
Mical Paul ◽  
Leonard Leibovici ◽  
Gafter Uzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Oral Iron ◽  
Dialysis Patients ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Iron Preparation ◽  
Iv Iron

Abstract Background: There is confounding data regarding the best method of iron supplementation in chronic kidney disease (CKD), without a consistent approach in clinical practice. Objectives: To evaluate the efficacy and safety of intravenous (IV) iron versus oral iron in patients treated for anemia of CKD. Methods: Systematic review and meta-analysis of randomized controlled trials comparing IV iron preparation with oral iron preparation for the treatment of anemia in patients with CKD (stage III, IV and V). The Cochrane Library, MEDLINE, conference proceedings and references were searched until 2007. Primary outcomes: absolute hemoglobin (Hb) level or change in Hb level from baseline at two months or at end of study; all-cause mortality. Secondary outcomes: need for renal replacement therapy (RRT) in predialysis patient and adverse events. Weighted mean differences (WMD) for outcomes with continuous variables and relative risks (RR) for dichotomous outcomes with 95% confidence intervals (CI) were estimated and pooled. Results: Our search yielded 11 trials which compared IV iron preparations (iron sucrose, iron gluconate or iron dextran) to oral iron. Compared to oral iron, there was a significant rise in Hb level in the IV iron treated hemodialysis patients (WMD 1.17; 95%CI 0.19–2.15, fig). Significant heterogeneity was observed due to different baseline Hb values and baseline iron status, different dosages of oral iron, and different dosages of erythropoiesis stimulating agents (ESA). For predialysis patients, there was a small but significant difference in the Hb level favoring the IV iron group (WMD 0.28; 95% CI 0.15–0.4, fig). For both groups effect estimates were not influenced by ESA administration. In predialysis patients, there was no significant difference in the risk for requiring RRT during the trial between the different groups (RR 0.63; 95%CI 0.25–1.65). Data on all-cause mortality were sparse (RR 0.54; 95%CI 0.09–3.13, 3 trials) and there was no difference in adverse events (RR 0.9; 95%CI 0.65–1.24) between the IV and oral treated patients. However, discontinuations of treatment were more common (RR 3.27; 95%CI 1.15–9.26) for the IV iron treated patients. Conclusions: Our review demonstrates that dialysis patients treated with IV iron have better Hb response than patients treated with oral iron. For predialysis patients, this effect is very small. IV iron should be preferred in the treatment of anemia in dialysis patients. In predialysis patients the slight advantage in Hb response should be weighed against the inconvenience and cost of IV iron treatment.

scholarly journals Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

2019 ◽  
Author(s):  
Jie Qin ◽  
Tingting Fu ◽  
Qi Tang ◽  
Lu Yang ◽  
Min Chen
Keyword(s):  
Meta Analysis ◽  
Corneal Biomechanics ◽  
Cochrane Library ◽  
Surgical Methods ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
Lenticule Extraction ◽  
The Difference ◽  
The Cochrane Library ◽  
Chinese Group

Abstract Background: To evaluate and compare corneal biomechanics after treatment of myopia using small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods: We performed a meta-analysis and searched for reports concerning corneal biomechanics after SMILE and FS-LASIK using MEDLINE, EMbase, CNKI and the Cochrane Library. The analysis included corneal hysteresis (CH) and corneal resistance factor (CRF) before and 3 months after the surgery. The quality of the reports was evaluated using the Newcastle-Ottawa scale (NOS). Statistical analysis was performed using RevMan5. Results: Only six studies with a total of 771 eyes were ultimately included in this meta-analysis, and the random effects model was adopted. The preoperative and three-month postoperative CH and CRF of SMILE and FS-LASIK were compared by the meta-analysis. No statistically significant difference was found in CH or CRF between the SMILE group and the FS-LASIK group before the surgery (WMD，-0.12; 95% CI，-0.31～0.06; P，0.19; WMD，-0.05; 95% CI，-0.29～0.19; P，0.69). There was no statistically significant difference in CH between the two surgical methods 3 months after the operation in the foreign group (WMD，0.19; 95% CI，-1.02～1.41; P，0.75) or in the Chinese group (WMD，0.13; 95% CI，-0.16～0.41; P，0.75). Likewise, no statistically significant difference was found in CRF between the two surgical methods in the foreign group 3 months after the operation (WMD，-0.11; 95% CI，-2.53～-2.31; P，0.93). Nevertheless, the difference in CRF between the two surgical methods was statistically significant in the Chinese group (WMD，0.26; 95% CI，0.06～0.47; P，0.01). Concusion: This meta-analysis indicated that SMILE showed no significant postoperative advantage in CH in comparison with FS-LASIK. For CRF, SMILE exhibited no obvious postoperative advantage in comparison with FS-LASIK in the foreign group, whereas SMILE was superior to FS-LASIK in the Chinese group.

Retinal vein occlusion and chronic kidney disease: A meta-analysis

2020 ◽  
pp. 112067212093766
Author(s):  
Li Jian Fang ◽  
Li Dong ◽  
Yi Fan Li ◽  
Wen Bin Wei
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Retinal Vein Occlusion ◽  
Meta Analysis ◽  
Population Based ◽  
Cochrane Library ◽  
Vein Occlusion ◽  
Pooled Prevalence ◽  
Stage Renal Disease ◽  
Esrd Patients

Objectives: We performed this meta-analysis to assess the correlation of retinal vein occlusion (RVO) and chronic kidney disease (CKD). Methods: We searched PubMed, Embase, Web of Science and Cochrane Library for population-based studies reporting the CKD as associated factor to RVO, central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Then we pooled the data for analysis. Results: After screening potential literature, 12 eligible studies with 23,656,214 individuals were finally included in quantitative synthesis. The pooled prevalence (95% confidence interval [CI]) of CKD in RVO group was 10.9% (95% CI: 6.6%, 15.1%). The pooled prevalence of any RVO in end stage renal disease (ESRD) group was 1.8% (95% CI: 1.6%, 2.1%). The prevalence of CKD was significantly higher in subjects diagnosed with RVO than non-RVO participants (odds ratio [OR]: 3.30; 95% CI: 2.28, 4.76; p < 0.001). CRVO subjects had a higher prevalence of CKD than BRVO patients (OR: 2.17; 95% CI: 1.28, 4.66; p = 0.004). In a similar manner, compared to non-ESRD subjects, ESRD patients had significantly higher prevalence of RVO (OR: 2.19; 95% CI: 1.97, 2.43; p < 0.001), CRVO (OR: 2.61; 95% CI: 2.17, 3.15; p < 0.001) and BRVO (OR: 2.01; 95% CI: 1.76, 2.30; p < 0.001). Conclusion: The prevalence of CKD increases in RVO patients, especially in CRVO. And in turn, the prevalence of RVO also increases in ESRD patients. The data support a correlation of RVO and CKD.

scholarly journals Diagnostic value of the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations in diabetic patients: a systematic review and meta-analysis

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092595
Author(s):  
Xie Lingli ◽  
Zhang Qing ◽  
Xia Wenfang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Disease Epidemiology ◽  
Individual Level ◽  
The Individual

Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations are common for calculating estimated glomerular filtration rate (eGFR). Unlike CKD, the key pathological change of diabetic kidney disease (DKD) is glomerulosclerosis. Methods To conduct a meta-analysis of the diagnostic performance of the CKD-EPI and MDRD equations in diabetic patients, we searched PubMed, Embase and the Cochrane Library for studies comparing standard GFR (sGFR) with eGFR using these two equations. Results Thirteen studies of 7192 diabetic patients reporting data on bias or accuracy were included. At the study level, both equations underestimated eGFR. CKD-EPI was more accurate in studies with mean GFR ≥60 mL/minute/1.73 m2. At the individual level, both equations overestimated GFR by 6.38 mL/minute/1.73 m2 (95% confidence interval [CI] 2.67–10.1) and 7.65 mL/minute/1.73 m2 (95% CI 2.78–12.52), respectively, for sGFR < 90 mL/minute/1.73 m2. The CKD-EPI equation was 7.61% (95% CI 4.66–10.56) more accurate in subjects with sGFR > 90 mL/minute/1.73 m2. The CKD-EPI equation performed poorly in diabetic patients. Conclusions The CKD-EPI equation can be used to estimate GFR in patients with incipient DKD, but has drawbacks. Improved eGFR equations suitable for diabetic populations are needed.

scholarly journals Effects of exercise on kidney and physical function in patients with non-dialysis chronic kidney disease: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Keisuke Nakamura ◽  
Tomohiro Sasaki ◽  
Shuhei Yamamoto ◽  
Hiroto Hayashi ◽  
Shinji Ako ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Exercise Training ◽  
Usual Care ◽  
Physical Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Risk Of Mortality ◽  
Walking Capacity ◽  
Physical Functions

Abstract Patients with non-dialysis chronic kidney disease (CKD) are at greater risk of early mortality and decreased physical function with an advance in the stage of CKD. However, the effect of exercise in these patients is unclear. This meta-analysis aimed to determine the effects of physical exercise training on the risk of mortality, kidney and physical functions, and adverse events in patients with non-dialysis CKD. The meta-analysis conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the Cochrane Handbook recommendations. On 16 August 2019, the PubMed, CINAHL, Cochrane Library databases, and Embase were electronically searched, with no restrictions for date/time, language, document type, or publication status, for eligible randomized controlled trials (RCTs) investigating the effects of exercise on mortality and kidney and physical function in patients with non-dialysis CKD. Eighteen trials (28 records), including 848 patients, were analyzed. The effects of exercise on all-cause mortality and estimated glomerular filtration rate were not significantly different from that of usual care. Exercise training improved peak/maximum oxygen consumption compared to usual care. Regular exercise improves physical and walking capacity for patients with non-dialysis CKD. Effect on leg muscle strength was unclear.

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