PDF(Pubmed)
Abstract：
UNASSIGNED: Residual kidney function (RKF) impacts patients\' survival rate and quality of life when undergoing peritoneal dialysis (PD). This meta-analysis was conducted to systematically identify risk and protective factors associated with RKF decline and loss.
UNASSIGNED: We searched three English and one Chinese databases from inception to January 31, 2023, for cohort and cross-sectional studies exploring factors associated with RKF decline or loss. The random effects model was employed to aggregate risk estimates and 95% confidence intervals (CIs) from multivariate analysis. Sensitivity and subgroup analyses were performed to explore the heterogeneity among the studies.
UNASSIGNED: Twenty-seven studies comprising 13549 individuals and 14 factors were included in the meta-analysis. Based on the meta-analysis results, risk factors involving male gender (hazard ratio (HR) 1.689, 95%CI 1.385-2.061), greater body mass index (BMI) (odds ratio (OR) 1.081, 95% confidence interval (CI) 1.029-1.135), higher systolic blood pressure (SBP) (HR 1.014, 95%CI 1.005-1.024), diabetes mellitus (DM) (HRRKF loss 1.873, 95%CI 1.475-2.378), DM (ORRKF decline 1.906, 95%CI 1.262-2.879), peritonitis (relative ratio (RR) 2.291, 95%CI 1.633-3.213), proteinuria (OR 1.223, 95%CI 1.117-1.338), and elevated serum phosphorus (RR 2.655, 95%CI 1.679-4.201) significantly contributed to the risk of RKF decline and loss in PD patients. Conversely, older age (HR 0.968, 95%CI 0.956-0.981), higher serum albumin (OR 0.834, 95%CI 0.720-0.966), weekly Kt/V urea (HR 0.414, 95%CI 0.248-0.690), baseline urine volume (UV) (HR 0.791, 95%CI 0.639-0.979), baseline RKF (HR 0.795, 95%CI 0.739-0.857) exhibited protective effects. However, diuretics use, automatic peritoneal dialysis (APD) modality and baseline RKF did not significantly impact RKF decline.
UNASSIGNED: Patients with male gender, greater BMI, higher SBP, DM, peritonitis, proteinuria, and elevated serum phosphorus might have a higher risk of RKF decline and loss. In contrast, older age, higher serum albumin, weekly Kt/V urea, baseline UV, and baseline RKF might protect against RKF deterioration.
UNASSIGNED: We searched three English and one Chinese databases from inception to January 31, 2023, for cohort and cross-sectional studies exploring factors associated with RKF decline or loss. The random effects model was employed to aggregate risk estimates and 95% confidence intervals (CIs) from multivariate analysis. Sensitivity and subgroup analyses were performed to explore the heterogeneity among the studies.
UNASSIGNED: Twenty-seven studies comprising 13549 individuals and 14 factors were included in the meta-analysis. Based on the meta-analysis results, risk factors involving male gender (hazard ratio (HR) 1.689, 95%CI 1.385-2.061), greater body mass index (BMI) (odds ratio (OR) 1.081, 95% confidence interval (CI) 1.029-1.135), higher systolic blood pressure (SBP) (HR 1.014, 95%CI 1.005-1.024), diabetes mellitus (DM) (HRRKF loss 1.873, 95%CI 1.475-2.378), DM (ORRKF decline 1.906, 95%CI 1.262-2.879), peritonitis (relative ratio (RR) 2.291, 95%CI 1.633-3.213), proteinuria (OR 1.223, 95%CI 1.117-1.338), and elevated serum phosphorus (RR 2.655, 95%CI 1.679-4.201) significantly contributed to the risk of RKF decline and loss in PD patients. Conversely, older age (HR 0.968, 95%CI 0.956-0.981), higher serum albumin (OR 0.834, 95%CI 0.720-0.966), weekly Kt/V urea (HR 0.414, 95%CI 0.248-0.690), baseline urine volume (UV) (HR 0.791, 95%CI 0.639-0.979), baseline RKF (HR 0.795, 95%CI 0.739-0.857) exhibited protective effects. However, diuretics use, automatic peritoneal dialysis (APD) modality and baseline RKF did not significantly impact RKF decline.
UNASSIGNED: Patients with male gender, greater BMI, higher SBP, DM, peritonitis, proteinuria, and elevated serum phosphorus might have a higher risk of RKF decline and loss. In contrast, older age, higher serum albumin, weekly Kt/V urea, baseline UV, and baseline RKF might protect against RKF deterioration.
摘要：
■腹膜透析（PD）时，残余肾功能（RKF）会影响患者的生存率和生活质量。这项荟萃分析旨在系统地确定与RKF下降和损失相关的风险和保护因素。
■从成立到2023年1月31日，我们搜索了三个英文数据库和一个中文数据库，以进行队列和横断面研究，探索与RKF下降或损失相关的因素。随机效应模型用于汇总来自多变量分析的风险估计和95%置信区间(CI)。进行敏感性和亚组分析以探索研究之间的异质性。
■27项研究包括13549名个体和14个因素纳入荟萃分析。根据荟萃分析结果，涉及男性性别的危险因素（危险比（HR）1.689，95CI1.385-2.061），较大的体重指数（BMI）（比值比（OR）1.081，95％置信区间（CI）1.029-1.135），较高的收缩压（SBP）（HR1.014，95CI1.005-1.024），糖尿病（DM）（HRRKF损失1.873，95CI1.475-2.378），DM（ORRKF下跌1.906，95CI1.262-2.879），腹膜炎（相对比率（RR）2.291，95CI1.633-3.213），蛋白尿（OR1.223，95CI1.117-1.338），和血清磷升高（RR2.655，95CI1.679-4.201）显着导致PD患者RKF下降和丢失的风险。相反，年龄较大（HR0.968，95CI0.956-0.981），高血清白蛋白（OR0.834，95CI0.720-0.966），每周Kt/V尿素（HR0.414，95CI0.248-0.690），基线尿量（UV）（HR0.791，95CI0.639-0.979），基线RKF（HR0.795，95CI0.739-0.857）表现出保护作用。然而,利尿剂的使用，自动腹膜透析(APD)模式和基线RKF对RKF下降无显著影响.
■男性患者，更大的BMI，更高的SBP，DM,腹膜炎,蛋白尿,血清磷升高可能有更高的RKF下降和丢失的风险。相比之下,年龄较大,血清白蛋白较高，每周Kt/V尿素，基线UV,和基线RKF可能防止RKF恶化。
■从成立到2023年1月31日，我们搜索了三个英文数据库和一个中文数据库，以进行队列和横断面研究，探索与RKF下降或损失相关的因素。随机效应模型用于汇总来自多变量分析的风险估计和95%置信区间(CI)。进行敏感性和亚组分析以探索研究之间的异质性。
■27项研究包括13549名个体和14个因素纳入荟萃分析。根据荟萃分析结果，涉及男性性别的危险因素（危险比（HR）1.689，95CI1.385-2.061），较大的体重指数（BMI）（比值比（OR）1.081，95％置信区间（CI）1.029-1.135），较高的收缩压（SBP）（HR1.014，95CI1.005-1.024），糖尿病（DM）（HRRKF损失1.873，95CI1.475-2.378），DM（ORRKF下跌1.906，95CI1.262-2.879），腹膜炎（相对比率（RR）2.291，95CI1.633-3.213），蛋白尿（OR1.223，95CI1.117-1.338），和血清磷升高（RR2.655，95CI1.679-4.201）显着导致PD患者RKF下降和丢失的风险。相反，年龄较大（HR0.968，95CI0.956-0.981），高血清白蛋白（OR0.834，95CI0.720-0.966），每周Kt/V尿素（HR0.414，95CI0.248-0.690），基线尿量（UV）（HR0.791，95CI0.639-0.979），基线RKF（HR0.795，95CI0.739-0.857）表现出保护作用。然而,利尿剂的使用，自动腹膜透析(APD)模式和基线RKF对RKF下降无显著影响.
■男性患者，更大的BMI，更高的SBP，DM,腹膜炎,蛋白尿,血清磷升高可能有更高的RKF下降和丢失的风险。相比之下,年龄较大,血清白蛋白较高，每周Kt/V尿素，基线UV,和基线RKF可能防止RKF恶化。
