Abstract：
UNASSIGNED: To estimate the predictors, prevalence and prognostic role of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD) using meta-analysis.
UNASSIGNED: The PubMed, EmBase, and the Cochrane library were systematically searched for eligible studies from inception till May 2024. All of pooled analyses were performed using the random-effects model.
UNASSIGNED: Fifty observational studies involving 17,558 CKD patients were selected. The prevalence of PH in CKD patients was 38% (95% confidence interval [CI]: 33%-43%), and the prevalence according to CKD status were 31% (95% CI: 20%-42%) for CKD (I-V), 39% (95% CI: 25%-54%) for end stage kidney disease (ESKD) (predialysis), 42% (95% CI: 35%-50%) for ESKD (hemodialysis), and 26% (95% CI: 19%-34%) for renal transplant. We noted the risk factors for PH in CKD included Black individuals (relative risk [RR]: 1.39; 95% CI: 1.18-1.63; p < 0.001), chronic obstructive pulmonary disease (RR: 1.48; 95% CI: 1.21-1.82; p < 0.001), cardiovascular disease history (RR: 1.62; 95% CI: 1.05-2.51; p = 0.030), longer dialysis (RR: 1.70; 95% CI: 1.18-2.46; p = 0.005), diastolic dysfunction (RR: 1.88; 95% CI: 1.38-2.55; p < 0.001), systolic dysfunction (RR: 3.75; 95% CI: 2.88-4.87; p < 0.001), and grade 5 CKD (RR: 5.64; 95% CI: 3.18-9.98; p < 0.001). Moreover, PH in CKD patients is also associated with poor prognosis, including all-cause mortality, major cardiovascular events, and cardiac death.
UNASSIGNED: This study systematically identified risk factors for PH in CKD patients, and PH were associated with poor prognosis. Therefore, patients with high prevalence of PH should be identified for treatment.
UNASSIGNED: The PubMed, EmBase, and the Cochrane library were systematically searched for eligible studies from inception till May 2024. All of pooled analyses were performed using the random-effects model.
UNASSIGNED: Fifty observational studies involving 17,558 CKD patients were selected. The prevalence of PH in CKD patients was 38% (95% confidence interval [CI]: 33%-43%), and the prevalence according to CKD status were 31% (95% CI: 20%-42%) for CKD (I-V), 39% (95% CI: 25%-54%) for end stage kidney disease (ESKD) (predialysis), 42% (95% CI: 35%-50%) for ESKD (hemodialysis), and 26% (95% CI: 19%-34%) for renal transplant. We noted the risk factors for PH in CKD included Black individuals (relative risk [RR]: 1.39; 95% CI: 1.18-1.63; p < 0.001), chronic obstructive pulmonary disease (RR: 1.48; 95% CI: 1.21-1.82; p < 0.001), cardiovascular disease history (RR: 1.62; 95% CI: 1.05-2.51; p = 0.030), longer dialysis (RR: 1.70; 95% CI: 1.18-2.46; p = 0.005), diastolic dysfunction (RR: 1.88; 95% CI: 1.38-2.55; p < 0.001), systolic dysfunction (RR: 3.75; 95% CI: 2.88-4.87; p < 0.001), and grade 5 CKD (RR: 5.64; 95% CI: 3.18-9.98; p < 0.001). Moreover, PH in CKD patients is also associated with poor prognosis, including all-cause mortality, major cardiovascular events, and cardiac death.
UNASSIGNED: This study systematically identified risk factors for PH in CKD patients, and PH were associated with poor prognosis. Therefore, patients with high prevalence of PH should be identified for treatment.
摘要：
■要估计预测因子，慢性肾脏病(CKD)患者肺动脉高压(PH)的患病率和预后作用的Meta分析.
■PubMed，Embase,从开始到2024年5月，系统搜索了Cochrane图书馆的合格研究。所有的汇总分析均使用随机效应模型进行。
■选择了涉及17,558名CKD患者的50项观察性研究。CKD患者中PH的患病率为38%(95%置信区间[CI]:33%-43%),根据CKD状态，CKD（I-V）的患病率为31％（95％CI：20％-42％），39％（95％CI：25％-54％）用于终末期肾脏疾病（ESKD）（透析前），42％（95％CI：35％-50％）用于ESKD（血液透析），26％（95％CI：19％-34％）用于肾移植。我们注意到CKD中PH的危险因素包括Black个体（相对风险[RR]：1.39;95％CI：1.18-1.63;p<0.001），慢性阻塞性肺疾病（RR：1.48;95％CI：1.21-1.82;p<0.001），心血管疾病史（RR：1.62；95%CI：1.05-2.51；p=0.030），更长的透析时间（RR：1.70；95%CI：1.18-2.46；p=0.005），舒张功能障碍（RR：1.88;95%CI：1.38-2.55;p<0.001），收缩功能障碍（RR：3.75；95%CI：2.88-4.87；p<0.001），和5级CKD（RR：5.64；95%CI：3.18-9.98；p<0.001）。此外，CKD患者的PH也与不良预后有关，包括全因死亡率,主要心血管事件，和心脏死亡。
■这项研究系统地确定了CKD患者PH的危险因素，PH与不良预后相关。因此,应明确PH患病率高的患者进行治疗.
■PubMed，Embase,从开始到2024年5月，系统搜索了Cochrane图书馆的合格研究。所有的汇总分析均使用随机效应模型进行。
■选择了涉及17,558名CKD患者的50项观察性研究。CKD患者中PH的患病率为38%(95%置信区间[CI]:33%-43%),根据CKD状态，CKD（I-V）的患病率为31％（95％CI：20％-42％），39％（95％CI：25％-54％）用于终末期肾脏疾病（ESKD）（透析前），42％（95％CI：35％-50％）用于ESKD（血液透析），26％（95％CI：19％-34％）用于肾移植。我们注意到CKD中PH的危险因素包括Black个体（相对风险[RR]：1.39;95％CI：1.18-1.63;p<0.001），慢性阻塞性肺疾病（RR：1.48;95％CI：1.21-1.82;p<0.001），心血管疾病史（RR：1.62；95%CI：1.05-2.51；p=0.030），更长的透析时间（RR：1.70；95%CI：1.18-2.46；p=0.005），舒张功能障碍（RR：1.88;95%CI：1.38-2.55;p<0.001），收缩功能障碍（RR：3.75；95%CI：2.88-4.87；p<0.001），和5级CKD（RR：5.64；95%CI：3.18-9.98；p<0.001）。此外，CKD患者的PH也与不良预后有关，包括全因死亡率,主要心血管事件，和心脏死亡。
■这项研究系统地确定了CKD患者PH的危险因素，PH与不良预后相关。因此,应明确PH患病率高的患者进行治疗.
