Abstract:BackgroundThe ankle—brachial blood pressure (BP) index (ABI) not only indicates the presence of peripheral artery occlusive disease (PAOD) but predicts mortality in patients undergoing hemodialysis (HD). However, whether the site of PAOD can provide additional contribution to predicting mortality have not been investigated yet. Our primary objective was to determine the associations between the site of PAOD and all-cause and cardiovascular mortality in chronic HD (CHD) patients.MethodsA retrospective cohort st… Show more
“…And 1 additional study was retrieved using hand searching the reference lists of included studies. Therefore, 10 cohort studies were included in this meta-analysis [8–17], of which 10 studies were included for meta-analysis of all-cause mortality [8–17], and 6 were included for CV mortality [8–10, 12, 15, 16]. Figure 1 showed the summary of study identification process.Fig.…”
Section: Resultsmentioning
confidence: 99%
“…5 articles were from Asia [9, 13–16], 2 from the United States [8, 11], 2 from Europe [12, 17], and 1 multinational study from Asia, USA and Europe [10]. An ABI value < 0.9 was the single diagnostic criteria of PAD in 4 studies [8, 9, 13, 15]. Of the 10 articles included, 8 reported the means duration of dialysis (min: 5.8 years; max: 19.8 years) [9, 11–13, 15–17].…”
Section: Resultsmentioning
confidence: 99%
“…An ABI value < 0.9 was the single diagnostic criteria of PAD in 4 studies [8, 9, 13, 15]. Of the 10 articles included, 8 reported the means duration of dialysis (min: 5.8 years; max: 19.8 years) [9, 11–13, 15–17]. For the 6 studies (2 were retrospective, and 4 were prospective, n = 31,794) included to analyze CVD mortality [8–10, 12, 15, 16], only 1 study did not use ABI < 0.9 to diagnose PAD [10].…”
Section: Resultsmentioning
confidence: 99%
“…For the 6 studies (2 were retrospective, and 4 were prospective, n = 31,794) included to analyze CVD mortality [8–10, 12, 15, 16], only 1 study did not use ABI < 0.9 to diagnose PAD [10]. …”
BackgroundRecent studies have shown an association between peripheral arterial disease (PAD) and increased risk of mortality in hemodialysis (HD) patients; however, the estimates vary widely and are inconsistent. It is necessary to elucidate the degree of mortality risk for PAD patients in HD population.MethodsPubMed, EMBASE, Web of Science and Cochrane Library (from inception to September 4th, 2016) were systematically searched for cohort studies assessing the association between PAD and mortality in HD patients. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CI) of all-cause and cardiovascular (CV) mortality using random effects models. Subgroup analyses were conducted to explore the source of heterogeneity.ResultsThe search identified 2,973 potentially eligible records and 10 studies (n = 32,864) were included. Our meta-analysis revealed that PAD significantly increased the risk of all-cause mortality (RR 2.15, 95 % CI 1.67–2.77, n = 32,864) and CV mortality (RR 2.99, 95 % CI 1.66-5.38, n = 31,794) in HD patients after multivariate adjustment. Subgroup analyses showed the study design and follow-up time might be two sources of heterogeneity.ConclusionPAD may be a prognostic marker of all-cause and CV mortality in HD patients. More attention should be paid to diagnosis and management of PAD in HD patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0397-1) contains supplementary material, which is available to authorized users.
“…And 1 additional study was retrieved using hand searching the reference lists of included studies. Therefore, 10 cohort studies were included in this meta-analysis [8–17], of which 10 studies were included for meta-analysis of all-cause mortality [8–17], and 6 were included for CV mortality [8–10, 12, 15, 16]. Figure 1 showed the summary of study identification process.Fig.…”
Section: Resultsmentioning
confidence: 99%
“…5 articles were from Asia [9, 13–16], 2 from the United States [8, 11], 2 from Europe [12, 17], and 1 multinational study from Asia, USA and Europe [10]. An ABI value < 0.9 was the single diagnostic criteria of PAD in 4 studies [8, 9, 13, 15]. Of the 10 articles included, 8 reported the means duration of dialysis (min: 5.8 years; max: 19.8 years) [9, 11–13, 15–17].…”
Section: Resultsmentioning
confidence: 99%
“…An ABI value < 0.9 was the single diagnostic criteria of PAD in 4 studies [8, 9, 13, 15]. Of the 10 articles included, 8 reported the means duration of dialysis (min: 5.8 years; max: 19.8 years) [9, 11–13, 15–17]. For the 6 studies (2 were retrospective, and 4 were prospective, n = 31,794) included to analyze CVD mortality [8–10, 12, 15, 16], only 1 study did not use ABI < 0.9 to diagnose PAD [10].…”
Section: Resultsmentioning
confidence: 99%
“…For the 6 studies (2 were retrospective, and 4 were prospective, n = 31,794) included to analyze CVD mortality [8–10, 12, 15, 16], only 1 study did not use ABI < 0.9 to diagnose PAD [10]. …”
BackgroundRecent studies have shown an association between peripheral arterial disease (PAD) and increased risk of mortality in hemodialysis (HD) patients; however, the estimates vary widely and are inconsistent. It is necessary to elucidate the degree of mortality risk for PAD patients in HD population.MethodsPubMed, EMBASE, Web of Science and Cochrane Library (from inception to September 4th, 2016) were systematically searched for cohort studies assessing the association between PAD and mortality in HD patients. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CI) of all-cause and cardiovascular (CV) mortality using random effects models. Subgroup analyses were conducted to explore the source of heterogeneity.ResultsThe search identified 2,973 potentially eligible records and 10 studies (n = 32,864) were included. Our meta-analysis revealed that PAD significantly increased the risk of all-cause mortality (RR 2.15, 95 % CI 1.67–2.77, n = 32,864) and CV mortality (RR 2.99, 95 % CI 1.66-5.38, n = 31,794) in HD patients after multivariate adjustment. Subgroup analyses showed the study design and follow-up time might be two sources of heterogeneity.ConclusionPAD may be a prognostic marker of all-cause and CV mortality in HD patients. More attention should be paid to diagnosis and management of PAD in HD patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0397-1) contains supplementary material, which is available to authorized users.
“…Furthermore, the ABI is a predictor of all-cause or cardiovascular mortality in CHD patients1213141516. A lower (<1.0) or higher (>1.4) ABI value in CKD patients induces a higher event rate of acute myocardial infarction or cardiovascular disease (CVD)17.…”
The cardiothoracic ratio (CTR) and peripheral arterial occlusive disease (PAOD) are related to mortality in hemodialysis patients. However, data on the association between PAOD and CTR are limited. In this study, we aim to elucidate this relationship in patients on chronic hemodialysis. Using a retrospective cross-sectional study of 622 Taiwanese patients, we investigated the association of PAOD and CTR. PAOD was significantly associated with CTR in the crude analysis. The odds ratio (OR) for CTR >0.5 was 1.77 [95% confidence interval (CI), 1.32–2.37], and the odds ratio for CTR >0.6 was 2.18 [95% CI, 1.44–3.30]. After adjusting for confounding variables, this difference continued to exhibit significant predictive power for CTR >0.6 (OR, 1.88; 95% CI, 1.14–3.11), but the predictive power for CTR >0.5 was attenuated (OR, 1.41; 95% CI, 0.98–2.03). In the subgroup analysis, PAOD was an independent factor for CTR >0.6, particularly in elderly and female patients or patients with hemoglobin >10 mg/dl and with no history of cardiovascular disease. In this research, we showed that the detection of PAOD was independently associated with CTR >0.6 in patients on chronic hemodialysis.
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