METHODS: PubMed, Ovid/Medline, Web of Science, Scopus, and Cochrane Library databases were screened and studies evaluating the effect of PTDM on all-cause mortality, cardiovascular mortality, sepsis-related mortality, malignancy-related mortality, and overall graft loss in adult kidney transplant recipients were included.
RESULTS: 53 studies, encompassing a total of 138,917 patients, to evaluate the association between PTDM and clinical outcomes were included. Our analysis revealed a significant increase in all-cause mortality (RR 1.70, 95% CI 1.53 to 1.89, P<0.001) and cardiovascular mortality (RR 1.86, 95% CI 1.36 to 2.54, P<0.001) among individuals with PTDM. Moreover, PTDM was associated with a higher risk of sepsis-related mortality (RR 1.96, 95% CI 1.51 to 2.54, P<0.001) but showed no significant association with malignancy-related mortality (RR 1.20, 95% CI 0.76 to 1.88). Additionally, PTDM was linked to an increased risk of overall graft failure (RR 1.33, 95% CI 1.16 to 1.54, P<0.001).
CONCLUSIONS: These findings underscore the importance of comprehensive management strategies and the need for research targeting PTDM to improve outcomes in kidney transplant recipients.
方法:PubMed,Ovid/Medline,WebofScience,Scopus,和Cochrane图书馆数据库被筛选和研究评估PTDM对全因死亡率的影响,心血管死亡率,脓毒症相关死亡率,恶性肿瘤相关死亡率,并纳入了成人肾移植受者的总体移植物丢失。
结果:53项研究,涵盖总共138,917名患者,评估PTDM与临床结局之间的相关性.我们的分析显示,PTDM患者的全因死亡率(RR1.70,95%CI1.53至1.89,P<0.001)和心血管死亡率(RR1.86,95%CI1.36至2.54,P<0.001)显著增加。此外,PTDM与脓毒症相关死亡率风险较高相关(RR1.96,95%CI1.51~2.54,P<0.001),但与恶性肿瘤相关死亡率无显著相关性(RR1.20,95%CI0.76~1.88)。此外,PTDM与总体移植物衰竭风险增加相关(RR1.33,95%CI1.16~1.54,P<0.001)。
结论:这些发现强调了全面管理策略的重要性,以及针对PTDM的研究需要改善肾移植受者的预后。