Weifeng Shang1, Yuanyuan Li2, Yali Ren3, Wei Li1, HongLan Wei1, Junwu Dong4. 1. Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China. 2. Department of Respiratory Medicine, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China. 3. Department of Medical Affaires, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China. 4. Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China. junwudongwuhan@163.com.
Abstract
PURPOSE: Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis. METHODS: PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias. RESULTS: Twenty-one observational studies (n = 8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23-42%), with significant heterogeneity between these studies (I2 = 98%, P < 0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP ≥ 35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias. CONCLUSIONS: PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.
PURPOSE: Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis. METHODS: PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias. RESULTS: Twenty-one observational studies (n = 8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23-42%), with significant heterogeneity between these studies (I2 = 98%, P < 0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP ≥ 35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias. CONCLUSIONS: PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.
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