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Meta-Analysis
. 2016 Nov 25;17(1):195.
doi: 10.1186/s12882-016-0397-1.

Association of peripheral arterial disease with all-cause and cardiovascular mortality in hemodialysis patients: a meta-analysis

Yi Yang  1 , Yong Ning  1 , Weifeng Shang  2 , Ran Luo  1 , Lixi Li  1 , Shuiming Guo  1 , Gang Xu  1 , Xiaofeng He  3 , Shuwang Ge  1
Affiliations
Meta-Analysis

Association of peripheral arterial disease with all-cause and cardiovascular mortality in hemodialysis patients: a meta-analysis

Yi Yang et al. BMC Nephrol. .

Abstract

Background: Recent 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.

Methods: PubMed, 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.

Results: The 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.

Conclusion: PAD 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.

Keywords: Hemodialysis; Meta-analysis; Mortality; Peripheral arterial disease.

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Figures

Fig. 1
Fig. 1
Flow diagram of selection of studies
Fig. 2
Fig. 2
Association between PAD and risk of all-cause mortality in HD patients
Fig. 3
Fig. 3
Association between PAD and risk of CV mortality in HD patients
See this image and copyright information in PMC

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