Influence of different stages of chronic kidney disease on prognosis of patients with aortic stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis
- VernacularTitle:不同分期慢性肾脏疾病对主动脉瓣狭窄患者经导管主动脉瓣置换术预后影响的系统评价与 Meta 分析
- Author:
Jialu WANG
1
;
Shidong LIU
2
;
Xiangxiang HAN
1
;
Yimeng LI
1
;
Qianyue CONG
1
;
Hengjun AN
1
;
Bing SONG
2
Author Information
1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P. R. China
2. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve replacement;
chronic kidney disease;
prognosis;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(08):1049-1059
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the impact of chronic kidney disease (CKD) at different stages on prognosis of transcatheter aortic valve replacement (TAVR). Methods Databases including PubMed, the Cochrane Library, EMbase, Web of Science, CNKI, Wanfang and the Chinese Biomedical Literature Database (CBM) were searched by computer to collect cohort studies on impact of different stages of CKD on prognosis of TAVR from inception to July 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using Stata 15.0 software. Risk of study bias was assessed using the Newcastle-Ottawa Scale (NOS). Results A total of 17 cohort studies were included with NOS score≥6 points. The results of meta-analysis indicated that: compared with the patients without CKD, all-cause mortality of CKD stage 3 patients at 30 day (RR=1.29, 95%CI 1.22-1.37, P<0.001) and 1 year (RR=1.24, 95%CI 1.19-1.28, P<0.001), all-cause mortality of CKD stage 4 patients at 30 day (RR=2.10, 95%CI 1.90-2.31, P<0.001) and 1 year (RR=1.89, 95%CI 1.62-2.19, P<0.001), and all-cause mortality of CKD stage 5 patients at 30 day (RR=2.22, 95%CI 1.62-2.19, P<0.001) and 1 year (RR=2.24, 95%CI 1.75-2.87, P<0.001) were significantly increased and were associated with the severity of CKD. The occurrence rates of 1-year cardiovascular mortality, postoperative acute kidney injury and bleeding events were all higher in patients with CKD. Conclusion CKD at stages 3, 4 and 5 is associated with increased all-cause mortality after TAVR, and the higher the stage of CKD is, the higher the risk of all-cause mortality at 30-day and 1-year follow-up is. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
