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Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis

Pulmonary arterial hypertension (PH) has a high prevalence in chronic kidney disease (CKD) patients, especially those undergoing kidney transplantation (KT). We aimed to systematically review and calculate the pooled effect size of the literature evaluating the association between pre-existing PH do...

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Autores principales: Brinza, Crischentian, Covic, Adrian, Stefan, Anca Elena, Floria, Mariana, Popa, Iolanda Valentina, Scripcariu, Dragos-Viorel, Burlacu, Alexandru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999673/
https://www.ncbi.nlm.nih.gov/pubmed/35407552
http://dx.doi.org/10.3390/jcm11071944
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author Brinza, Crischentian
Covic, Adrian
Stefan, Anca Elena
Floria, Mariana
Popa, Iolanda Valentina
Scripcariu, Dragos-Viorel
Burlacu, Alexandru
author_facet Brinza, Crischentian
Covic, Adrian
Stefan, Anca Elena
Floria, Mariana
Popa, Iolanda Valentina
Scripcariu, Dragos-Viorel
Burlacu, Alexandru
author_sort Brinza, Crischentian
collection PubMed
description Pulmonary arterial hypertension (PH) has a high prevalence in chronic kidney disease (CKD) patients, especially those undergoing kidney transplantation (KT). We aimed to systematically review and calculate the pooled effect size of the literature evaluating the association between pre-existing PH documented by transthoracic echocardiography (TTE) or invasively and adverse outcomes following KT. The primary composite outcome extracted from the included studies was represented by the mortality from any cause following KT and delayed graft function (DGF), graft dysfunction, or graft failure. The secondary outcomes were represented by individual components of the primary composite outcome. Twelve studies meeting the inclusion criteria were selected. The main finding is that pre-existing PH was associated with increased mortality and a higher rate of DGF, kidney graft dysfunction, or failure in KT recipients. The effect remained significant for all outcomes irrespective of PH evaluation, invasively or using TTE. Consequently, patients with PH defined only by TTE were at higher risk of death, DGF, or graft failure. Our findings support the routine assessment of PH in patients on the KT waitlist. PH might represent an extensively available and valuable tool for risk stratification in KT patients. These data should be confirmed in large prospective clinical trials.
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spelling pubmed-89996732022-04-12 Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis Brinza, Crischentian Covic, Adrian Stefan, Anca Elena Floria, Mariana Popa, Iolanda Valentina Scripcariu, Dragos-Viorel Burlacu, Alexandru J Clin Med Review Pulmonary arterial hypertension (PH) has a high prevalence in chronic kidney disease (CKD) patients, especially those undergoing kidney transplantation (KT). We aimed to systematically review and calculate the pooled effect size of the literature evaluating the association between pre-existing PH documented by transthoracic echocardiography (TTE) or invasively and adverse outcomes following KT. The primary composite outcome extracted from the included studies was represented by the mortality from any cause following KT and delayed graft function (DGF), graft dysfunction, or graft failure. The secondary outcomes were represented by individual components of the primary composite outcome. Twelve studies meeting the inclusion criteria were selected. The main finding is that pre-existing PH was associated with increased mortality and a higher rate of DGF, kidney graft dysfunction, or failure in KT recipients. The effect remained significant for all outcomes irrespective of PH evaluation, invasively or using TTE. Consequently, patients with PH defined only by TTE were at higher risk of death, DGF, or graft failure. Our findings support the routine assessment of PH in patients on the KT waitlist. PH might represent an extensively available and valuable tool for risk stratification in KT patients. These data should be confirmed in large prospective clinical trials. MDPI 2022-03-31 /pmc/articles/PMC8999673/ /pubmed/35407552 http://dx.doi.org/10.3390/jcm11071944 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Brinza, Crischentian
Covic, Adrian
Stefan, Anca Elena
Floria, Mariana
Popa, Iolanda Valentina
Scripcariu, Dragos-Viorel
Burlacu, Alexandru
Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title_full Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title_fullStr Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title_full_unstemmed Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title_short Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis
title_sort pulmonary arterial hypertension and adverse outcomes after kidney transplantation: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999673/
https://www.ncbi.nlm.nih.gov/pubmed/35407552
http://dx.doi.org/10.3390/jcm11071944
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