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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

Risk of Bias Assessment
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Related In: Results  -  Collection

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Fig2: Risk of Bias Assessment

Mentions: The assessment of the risk of bias in the included studies is summarized in Fig. 2. Thirty-eight studies provided information regarding the setting, locations and dates of studies [14–19, 21–37, 40–43, 45–48, 51–57]. Furthermore, 34 of 42 studies (81 %) had clearly defined eligibility criteria [14, 15, 17–19, 21, 24–31, 33–38, 40–44, 46–48, 51–57]. Twenty one (50 %) studies had a low risk of selection bias based on their random or consecutive sampling method [15, 21, 24, 26, 29–31, 34–36, 41–43, 46, 48, 51, 52, 54, 55, 57]. The eligibility criteria and participant rate were described adequately in 29 studies (69 %) [14, 15, 19, 21, 24–31, 33–35, 37, 41–44, 46–48, 51–55, 57], and 15 studies (36 %) [19, 21, 24, 28–31, 35, 37, 42, 44, 47, 48, 54, 55] described the flow of participants and reasons of ineligibility. Thirty one studies (74 %) provided a clear description of the characteristics of the included participants [14, 15, 17–19, 21, 24, 26–35, 37, 41–46, 48, 51–56] and 24 studies (57 %) appropriately defined sudden cardiac death [15, 17, 19–21, 23, 27, 29, 31, 33–37, 41, 42, 46, 51–57]. Additionally, 26 and 13 studies acknowledged the sources of funding [14, 16, 18, 21, 23, 24, 26–29, 31–34, 36, 38, 41–43, 45, 47, 51–54, 56] and attrition [17–19, 21, 24, 27, 29, 31, 35, 37, 48, 51, 53, 55], respectively.Fig. 2


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)

Risk of Bias Assessment
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Risk of Bias Assessment
Mentions: The assessment of the risk of bias in the included studies is summarized in Fig. 2. Thirty-eight studies provided information regarding the setting, locations and dates of studies [14–19, 21–37, 40–43, 45–48, 51–57]. Furthermore, 34 of 42 studies (81 %) had clearly defined eligibility criteria [14, 15, 17–19, 21, 24–31, 33–38, 40–44, 46–48, 51–57]. Twenty one (50 %) studies had a low risk of selection bias based on their random or consecutive sampling method [15, 21, 24, 26, 29–31, 34–36, 41–43, 46, 48, 51, 52, 54, 55, 57]. The eligibility criteria and participant rate were described adequately in 29 studies (69 %) [14, 15, 19, 21, 24–31, 33–35, 37, 41–44, 46–48, 51–55, 57], and 15 studies (36 %) [19, 21, 24, 28–31, 35, 37, 42, 44, 47, 48, 54, 55] described the flow of participants and reasons of ineligibility. Thirty one studies (74 %) provided a clear description of the characteristics of the included participants [14, 15, 17–19, 21, 24, 26–35, 37, 41–46, 48, 51–56] and 24 studies (57 %) appropriately defined sudden cardiac death [15, 17, 19–21, 23, 27, 29, 31, 33–37, 41, 42, 46, 51–57]. Additionally, 26 and 13 studies acknowledged the sources of funding [14, 16, 18, 21, 23, 24, 26–29, 31–34, 36, 38, 41–43, 45, 47, 51–54, 56] and attrition [17–19, 21, 24, 27, 29, 31, 35, 37, 48, 51, 53, 55], respectively.Fig. 2

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