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Incidence of sudden cardiac death in adults with end-stage renal disease: a systematic review and meta-analysis.

Ramesh S, Zalucky A, Hemmelgarn BR, Roberts DJ, Ahmed SB, Wilton SB, Jun M - BMC Nephrol (2016)

Bottom Line: Forty two studies (n = 80,382 patients) were included in the meta-analysis.The definitions and assessment of SCD varied across the included studies.There was evidence of significant heterogeneity (I(2) = 98; p < 0.001), which was not explained by subgroup analyses stratified by mean age, proportion of hypertensive or diabetic patients, follow-up time, study size, or type of cohort studied.

View Article: PubMed Central - PubMed

Affiliation: Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

ABSTRACT

Background: Although sudden cardiac death (SCD) is recognized as a distinct cause of death in patients with end stage renal disease (ESRD), its incidence has not been well summarized.

Methods: We performed a systematic review and meta-analysis of the literature based on a protocol developed a priori. We searched MEDLINE and EMBASE (inception to March 2015) for randomized controlled trials and cohort studies reporting the incidence of SCD in adult patients with ESRD on hemodialysis or peritoneal dialysis. We collected data on number of SCD as well as the definition of SCD for each individual study. A random-effects model was used to summarize the incidence of SCD. We conducted subgroup analyses to explore sources of heterogeneity.

Results: Forty two studies (n = 80,382 patients) were included in the meta-analysis. The incidence of SCD among adults with ESRD ranged from 0.4 to 10.04 deaths per 100 person-years. The definitions and assessment of SCD varied across the included studies. There was evidence of significant heterogeneity (I(2) = 98; p < 0.001), which was not explained by subgroup analyses stratified by mean age, proportion of hypertensive or diabetic patients, follow-up time, study size, or type of cohort studied.

Conclusion: Current estimates of the incidence of SCD among adults with ESRD vary widely. There is a need for further studies to more accurately estimate the incidence of SCD in patients with ESRD.

No MeSH data available.


Related in: MedlinePlus

PRISMA flow diagram showing the identification process for eligible studies
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Fig1: PRISMA flow diagram showing the identification process for eligible studies

Mentions: The literature search yielded a total of 3,854 citations, of which 488 qualified for full text review (Fig. 1). The final analysis included 42 studies with 80,382 patients with ESRD reporting on 8,574 SCD events. The characteristics of the studies included in the systematic review are shown in Additional file 2. Of the 42 studies, 40 were cohort studies, 1 was a randomized controlled trial, and 2 were observational analyses of randomized controlled trials. 14 were from Asia [14–27], 17 from Europe [28–44], 7 from North America [30, 45–52], 1 from Oceania [53], 2 from South America [54, 55], and 1 international study conducted across centers in Europe, North America and Oceania [56]. The studies were published between 1985 and 2014 and the number of patients enrolled ranged from 22 to 37,765. Most studies were conducted in hemodialysis patients (71 %) with only two enrolling specifically peritoneal dialysis patients [27, 38]. The mean age of patients ranged from 44 to 71 years and the proportion of males ranged from 48 to 83 %. Data on comorbidities were generally limited. The proportion of patients with hypertension across the included studies ranged between 5 and 91 % while those with diabetes ranged between 6 and 100 %.Fig. 1


Incidence of sudden cardiac death in adults with end-stage renal disease: a systematic review and meta-analysis.

Ramesh S, Zalucky A, Hemmelgarn BR, Roberts DJ, Ahmed SB, Wilton SB, Jun M - BMC Nephrol (2016)

PRISMA flow diagram showing the identification process for eligible studies
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940956&req=5

Fig1: PRISMA flow diagram showing the identification process for eligible studies
Mentions: The literature search yielded a total of 3,854 citations, of which 488 qualified for full text review (Fig. 1). The final analysis included 42 studies with 80,382 patients with ESRD reporting on 8,574 SCD events. The characteristics of the studies included in the systematic review are shown in Additional file 2. Of the 42 studies, 40 were cohort studies, 1 was a randomized controlled trial, and 2 were observational analyses of randomized controlled trials. 14 were from Asia [14–27], 17 from Europe [28–44], 7 from North America [30, 45–52], 1 from Oceania [53], 2 from South America [54, 55], and 1 international study conducted across centers in Europe, North America and Oceania [56]. The studies were published between 1985 and 2014 and the number of patients enrolled ranged from 22 to 37,765. Most studies were conducted in hemodialysis patients (71 %) with only two enrolling specifically peritoneal dialysis patients [27, 38]. The mean age of patients ranged from 44 to 71 years and the proportion of males ranged from 48 to 83 %. Data on comorbidities were generally limited. The proportion of patients with hypertension across the included studies ranged between 5 and 91 % while those with diabetes ranged between 6 and 100 %.Fig. 1

Bottom Line: Forty two studies (n = 80,382 patients) were included in the meta-analysis.The definitions and assessment of SCD varied across the included studies.There was evidence of significant heterogeneity (I(2) = 98; p < 0.001), which was not explained by subgroup analyses stratified by mean age, proportion of hypertensive or diabetic patients, follow-up time, study size, or type of cohort studied.

View Article: PubMed Central - PubMed

Affiliation: Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

ABSTRACT

Background: Although sudden cardiac death (SCD) is recognized as a distinct cause of death in patients with end stage renal disease (ESRD), its incidence has not been well summarized.

Methods: We performed a systematic review and meta-analysis of the literature based on a protocol developed a priori. We searched MEDLINE and EMBASE (inception to March 2015) for randomized controlled trials and cohort studies reporting the incidence of SCD in adult patients with ESRD on hemodialysis or peritoneal dialysis. We collected data on number of SCD as well as the definition of SCD for each individual study. A random-effects model was used to summarize the incidence of SCD. We conducted subgroup analyses to explore sources of heterogeneity.

Results: Forty two studies (n = 80,382 patients) were included in the meta-analysis. The incidence of SCD among adults with ESRD ranged from 0.4 to 10.04 deaths per 100 person-years. The definitions and assessment of SCD varied across the included studies. There was evidence of significant heterogeneity (I(2) = 98; p < 0.001), which was not explained by subgroup analyses stratified by mean age, proportion of hypertensive or diabetic patients, follow-up time, study size, or type of cohort studied.

Conclusion: Current estimates of the incidence of SCD among adults with ESRD vary widely. There is a need for further studies to more accurately estimate the incidence of SCD in patients with ESRD.

No MeSH data available.


Related in: MedlinePlus