Cargando…
Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis
AIM: To understand the influence of chronic kidney disease (CKD) on mortality, need for transfusion and rebleeding in gastrointestinal (GI) bleeding patients. METHODS: A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or end-stage renal disease (ESRD)...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743512/ https://www.ncbi.nlm.nih.gov/pubmed/29308001 http://dx.doi.org/10.3748/wjg.v23.i47.8415 |
_version_ | 1783288581102501888 |
---|---|
author | Hágendorn, Roland Farkas, Nelli Vincze, Áron Gyöngyi, Zoltán Csupor, Dezső Bajor, Judit Erőss, Bálint Csécsei, Péter Vasas, Andrea Szakács, Zsolt Szapáry, László Hegyi, Péter Mikó, Alexandra |
author_facet | Hágendorn, Roland Farkas, Nelli Vincze, Áron Gyöngyi, Zoltán Csupor, Dezső Bajor, Judit Erőss, Bálint Csécsei, Péter Vasas, Andrea Szakács, Zsolt Szapáry, László Hegyi, Péter Mikó, Alexandra |
author_sort | Hágendorn, Roland |
collection | PubMed |
description | AIM: To understand the influence of chronic kidney disease (CKD) on mortality, need for transfusion and rebleeding in gastrointestinal (GI) bleeding patients. METHODS: A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or end-stage renal disease (ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization (LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane’s Q and I(2) statistics. Mean difference (MD) and OR (odds ratio) were calculated. RESULTS: 1063 articles (EMBASE: 589; PubMed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group (OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group (OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate (OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion (MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital (MD = 13.245, 95%CI: 6.886-19.623, P < 0.001) than the controls. CONCLUSION: ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed. |
format | Online Article Text |
id | pubmed-5743512 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-57435122018-01-05 Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis Hágendorn, Roland Farkas, Nelli Vincze, Áron Gyöngyi, Zoltán Csupor, Dezső Bajor, Judit Erőss, Bálint Csécsei, Péter Vasas, Andrea Szakács, Zsolt Szapáry, László Hegyi, Péter Mikó, Alexandra World J Gastroenterol Meta-Analysis AIM: To understand the influence of chronic kidney disease (CKD) on mortality, need for transfusion and rebleeding in gastrointestinal (GI) bleeding patients. METHODS: A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or end-stage renal disease (ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization (LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane’s Q and I(2) statistics. Mean difference (MD) and OR (odds ratio) were calculated. RESULTS: 1063 articles (EMBASE: 589; PubMed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group (OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group (OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate (OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion (MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital (MD = 13.245, 95%CI: 6.886-19.623, P < 0.001) than the controls. CONCLUSION: ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed. Baishideng Publishing Group Inc 2017-12-21 2017-12-21 /pmc/articles/PMC5743512/ /pubmed/29308001 http://dx.doi.org/10.3748/wjg.v23.i47.8415 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Meta-Analysis Hágendorn, Roland Farkas, Nelli Vincze, Áron Gyöngyi, Zoltán Csupor, Dezső Bajor, Judit Erőss, Bálint Csécsei, Péter Vasas, Andrea Szakács, Zsolt Szapáry, László Hegyi, Péter Mikó, Alexandra Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title_full | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title_fullStr | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title_full_unstemmed | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title_short | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis |
title_sort | chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: a meta-analysis |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743512/ https://www.ncbi.nlm.nih.gov/pubmed/29308001 http://dx.doi.org/10.3748/wjg.v23.i47.8415 |
work_keys_str_mv | AT hagendornroland chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT farkasnelli chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT vinczearon chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT gyongyizoltan chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT csupordezso chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT bajorjudit chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT erossbalint chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT csecseipeter chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT vasasandrea chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT szakacszsolt chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT szaparylaszlo chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT hegyipeter chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis AT mikoalexandra chronickidneydiseaseseverelydeterioratestheoutcomeofgastrointestinalbleedingametaanalysis |