■长五聚蛋白-3(PTX-3)作为预测慢性肾病(CKD)患者不良临床结果的生物标志物。当前荟萃分析的目的是评估PTX-3在CKD患者中的预后效果。此外,在相同的CKD患者队列中,我们比较了PTX-3和短正五合蛋白C反应蛋白(CRP)的预后效果.
■系统评价和荟萃分析。
■接受或不接受透析治疗的CKD患者。
■一项至少1年随访的队列研究。
■风险测量,用95%CI调整风险风险,并修改变量。
■要汇总调整后的效应估计值,采用固定效应或随机效应模型。
■本综述选择了9项研究,涵盖1,825例CKD患者。9项研究中有6项专门包括接受血液透析的患者。收集的结果表明,PTX-3最高三位数的CKD患者表现出明显更高的全因死亡率风险(HR,1.92;95%CI,1.44-2.56),心血管死亡(HR,1.98;95%CI,1.28-3.05),感染性死亡(HR,5.26;95%CI,1.60-17.31),以及致命和非致命的心血管事件(HR,1.81;95%CI,1.35-2.42),与最低三分位数的人相比。当根据PTX-3的单位变化呈现效应估计时,也观察到这些与风险的显著关联。此外,当比较PTX-3和CRP在同一个体中的预后价值时(5项研究涵盖904例患者),PTX-3被证明是这些患者不良事件的令人满意的预测因子,而CRP未能表现出这种预测能力,无论使用的效果估计类型如何。
■相对较小的样本量和一些异质性。
■Pentraxin3与CKD患者的不良事件相关,在该人群中,Pentraxin3可能是比CRP更可靠的不良临床事件预测因子。
全身性炎症标记物可用于预测CKD患者的预后。与pentraxin家族的其他成员相比,pentraxin-3(PTX-3)是一种新兴的炎症生物标志物,如C反应蛋白(CRP)。这项荟萃分析评估了PTX-3在预测CKD患者不良结局中的预后价值。此外,我们比较了部分研究中PTX-3和CRP与CRP的预后值.我们发现,与PTX-3水平较低的CKD患者相比,PTX-3水平较高的CKD患者发生不良后果的风险明显增加。相比之下,CRP似乎不是不良事件的良好预测因子。在CKD患者中,Pentraxin-3可能是比CRP更可靠的预后指标。
UNASSIGNED: Long pentraxin-3 (PTX-3) serves as a biomarker for prognosticating adverse clinical outcomes in individuals with chronic kidney disease (CKD). The objective of the current meta-analysis was to evaluate the prognostic efficacy of PTX-3 in patients with CKD. In addition, we compared the prognostic effectiveness of PTX-3 and the short pentraxin C-reactive protein (CRP) in the identical cohort of patients with CKD.
UNASSIGNED: A systematic review and meta-analysis.
UNASSIGNED: Patients with CKD treated with or without dialysis.
UNASSIGNED: A cohort study with a minimum 1-year follow-up.
UNASSIGNED: Risk measurements, adjusted hazard risk with 95% CI, and modified variables.
UNASSIGNED: To aggregate the adjusted effect estimates, a fixed-effects or random-effects model was employed.
UNASSIGNED: Nine studies covering 1,825 patients with CKD were selected in the present review. Six of the 9 studies exclusively included patients receiving hemodialysis. The collected findings indicated that patients with CKD in the highest tertile of PTX-3 demonstrated significantly higher risks of all-cause mortality (HR, 1.92; 95% CI, 1.44-2.56), cardiovascular death (HR, 1.98; 95% CI, 1.28-3.05), infectious death (HR, 5.26; 95% CI, 1.60-17.31), and fatal and nonfatal cardiovascular events (HR, 1.81; 95% CI, 1.35-2.42), as compared with those in the lowest tertile. These significant associations with risk were also observed when effect estimates were presented as per unit change in the PTX-3. Moreover, when comparing the prognostic value of PTX-3 and CRP in the same individuals (5 studies covering 904 patients), PTX-3 proved to be a satisfactory predictor of adverse events in these patients, whereas CRP failed to exhibit such predictive capability, regardless of the type of effect estimate used.
UNASSIGNED: A relatively small sample size and some heterogeneity.
UNASSIGNED: Pentraxin 3 is associated with adverse events in individuals with CKD and may be a more reliable predictor of adverse clinical events than CRP in this population.
Systemic inflammatory markers are useful in predicting the prognosis of patients with CKD. Pentraxin-3 (PTX-3) is an emerging biomarker of inflammation compared with other members of the pentraxin family, such as C-reactive protein (CRP). This meta-analysis evaluated the prognostic value of PTX-3 in predicting adverse outcomes in patients with CKD. Also, we compared the prognostic values between PTX-3 and CRP in the subset of studies with data on CRP. We found that patients with CKD with higher circulating PTX-3 levels had a significantly heightened risk of adverse outcomes compared with those with lower PTX-3 levels. By contrast, CRP did not appear to be a good predictor of adverse events. Pentraxin-3 might be a more reliable prognostic marker than CRP in patients with CKD.