FIR therapy can reduce AVFs occlusion rates and needling pain level, while significantly improve the level of vascular access blood flow, AVFs diameter and the primary AVFs patency.
Statins are effective lipid-lowering drugs with beneficial pleiotropic effects for vascular remodeling processes, statins may have a beneficial effect on the function of arteriovenous fistulas (AVFs) in hemodialysis (HD) patients. Therefore, we performed this systematic review to assess the protective effects of statin therapy in HD patients. The randomized controlled trials (RCTs) or quasiRCTs and retrospective cohort studies (RCS) of statin therapy for the function of AVFs in HD patients were searched from multiple databases. Relevant studies were screened according to predefined inclusion criteria and then pooled-analyses were performed using RevMan 5.2 software. One RCT and six RCS containing 20 246 HD patients were included in this meta-analysis, of whom 9847 were treated with statins and 10 399 were treated with placebo. Our meta-analysis showed that there was no significant difference between statins and placebo groups, with those who received statin therapy showing similar AVF failure rates compared to control (pooled risk ratio = 0.89; 95% CI, 0.70 to 1.12, P = 0.32), and there was obvious evidence of statistical heterogeneity (P = 0.005; I 2 = 68%). In addition, subgroup pooled analyses revealed that statin therapy did not ameliorate AVF failure in participants from the same racial background or similar sample size trials. There was no evidence that statins therapy could reduce the AVFs failure. However, due to methodological limitations and obvious statistical heterogeneity, high-quality, long-term and multicenter trials are required to fully elucidate the clinical value of statins administration for the outcomes of AVFs in HD patients.
Our pooled analysis aimed to assess the impact of vitamin D receptor (VDR) gene polymorphism on chronic renal failure (CRF) susceptibility. Relevant studies were searched from multiple databases, then pooled-analyses were performed using Stata software. Eighteen studies involving 2512 CRF patients and 3630 healthy controls were included. Pooled analysis showed that VDR ApaI and TaqI gene polymorphism were not associated with CRF susceptibility either in Asian or in Caucasians populations, and VDR BsmI and FokI gene polymorphism were not associated with CRF susceptibility in overall populations. The subgroup analysis showed that VDR BsmI gene polymorphism was associated with CRF susceptibility in Chinese under the Allele model (OR = 0.76, 95% CI: 0.59-0.97, P = 0.029). In Spanish individuals, VDR BsmI gene polymorphism was associated with CRF: Recessive model (BB vs. Bb + bb): OR = 1.60, 95% CI: 1.09-2.35, P = 0.016; Additive model (BB + bb vs. Bb): OR = 1.60, 95% CI: 1.21-2.12, P = 0.001). In addition, in the Asian subgroup, VDR FokI gene polymorphism was associated with CRF risk: Allele model (F vs. f): OR = 0.31, 95% CI: 0.16-0.59, P = 0.000; Dominant model (FF + Ff vs. ff): OR = 0.12, 95% CI: 0.03-0.59, P = 0.009 and Recessive model (FF vs. Ff + ff): OR = 0.32, 95% CI: 0.13-0.75, P = 0.009. This pooled analysis showed that VDR BsmI gene polymorphism was associated with CRF risk in the Chinese and Spanish individuals, and, VDR FokI gene polymorphism was associated with CRF risk in Asian subjects. But VDR ApaI and TaqI gene polymorphism were not associated with CRF risk either in Asian or in Caucasian individuals.
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