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Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses

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Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses. / Kim, Jong Yeob; Steingroever, Johanna; Lee, Keum Hwa; Oh, Jun; Choi, Min Jae; Lee, Jiwon; Larkins, Nicholas G; Schaefer, Franz; Hong, Sung Hwi; Jeong, Gwang Hun; Shin, Jae Il; Kronbichler, Andreas.

in: J CLIN MED, Jahrgang 9, Nr. 2, 01.02.2020.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Kim, JY, Steingroever, J, Lee, KH, Oh, J, Choi, MJ, Lee, J, Larkins, NG, Schaefer, F, Hong, SH, Jeong, GH, Shin, JI & Kronbichler, A 2020, 'Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses', J CLIN MED, Jg. 9, Nr. 2. https://doi.org/10.3390/jcm9020394

APA

Kim, J. Y., Steingroever, J., Lee, K. H., Oh, J., Choi, M. J., Lee, J., Larkins, N. G., Schaefer, F., Hong, S. H., Jeong, G. H., Shin, J. I., & Kronbichler, A. (2020). Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses. J CLIN MED, 9(2). https://doi.org/10.3390/jcm9020394

Vancouver

Kim JY, Steingroever J, Lee KH, Oh J, Choi MJ, Lee J et al. Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses. J CLIN MED. 2020 Feb 1;9(2). https://doi.org/10.3390/jcm9020394

Bibtex

@article{f20be7e260814ab39031215a5123ffb8,
title = "Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses",
abstract = "Patients with chronic kidney disease (CKD) have altered physiologic processes, which result in different treatment outcomes compared with the general population. We aimed to systematically evaluate the efficacy of clinical interventions in reducing mortality of patients with CKD. We searched PubMed, MEDLINE, Embase, and Cochrane Database of Systematic Reviews for meta-analyses of randomized controlled trials (RCT) or observational studies (OS) studying the effect of treatment on all-cause mortality of patients with CKD. The credibility assessment was based on the random-effects summary estimate, heterogeneity, 95% prediction intervals, small study effects, excess significance, and credibility ceilings. Ninety-two articles yielded 130 unique meta-analyses. Convincing evidence from OSs supported mortality reduction with three treatments: angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers for patients not undergoing dialysis, warfarin for patients with atrial fibrillation not undergoing dialysis, and (at short-term) percutaneous coronary intervention compared to coronary artery bypass grafting for dialysis patients. Two treatment comparisons were supported by highly credible evidence from RCTs in terms of all-cause mortality. These were high-flux hemodialysis (HD) versus low-flux HD as a maintenance HD method and statin versus less statin or placebo for patients not undergoing dialysis. Most significant associations identified in OSs failed to be replicated in RCTs. Associations of high credibility from RCTs were in line with current guidelines. Given the heterogeneity of CKD, it seems hard to assume mortality reductions based on findings from OSs.",
author = "Kim, {Jong Yeob} and Johanna Steingroever and Lee, {Keum Hwa} and Jun Oh and Choi, {Min Jae} and Jiwon Lee and Larkins, {Nicholas G} and Franz Schaefer and Hong, {Sung Hwi} and Jeong, {Gwang Hun} and Shin, {Jae Il} and Andreas Kronbichler",
year = "2020",
month = feb,
day = "1",
doi = "10.3390/jcm9020394",
language = "English",
volume = "9",
journal = "J CLIN MED",
issn = "2077-0383",
publisher = "MDPI AG",
number = "2",

}

RIS

TY - JOUR

T1 - Clinical Interventions and All-Cause Mortality of Patients with Chronic Kidney Disease: An Umbrella Systematic Review of Meta-Analyses

AU - Kim, Jong Yeob

AU - Steingroever, Johanna

AU - Lee, Keum Hwa

AU - Oh, Jun

AU - Choi, Min Jae

AU - Lee, Jiwon

AU - Larkins, Nicholas G

AU - Schaefer, Franz

AU - Hong, Sung Hwi

AU - Jeong, Gwang Hun

AU - Shin, Jae Il

AU - Kronbichler, Andreas

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Patients with chronic kidney disease (CKD) have altered physiologic processes, which result in different treatment outcomes compared with the general population. We aimed to systematically evaluate the efficacy of clinical interventions in reducing mortality of patients with CKD. We searched PubMed, MEDLINE, Embase, and Cochrane Database of Systematic Reviews for meta-analyses of randomized controlled trials (RCT) or observational studies (OS) studying the effect of treatment on all-cause mortality of patients with CKD. The credibility assessment was based on the random-effects summary estimate, heterogeneity, 95% prediction intervals, small study effects, excess significance, and credibility ceilings. Ninety-two articles yielded 130 unique meta-analyses. Convincing evidence from OSs supported mortality reduction with three treatments: angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers for patients not undergoing dialysis, warfarin for patients with atrial fibrillation not undergoing dialysis, and (at short-term) percutaneous coronary intervention compared to coronary artery bypass grafting for dialysis patients. Two treatment comparisons were supported by highly credible evidence from RCTs in terms of all-cause mortality. These were high-flux hemodialysis (HD) versus low-flux HD as a maintenance HD method and statin versus less statin or placebo for patients not undergoing dialysis. Most significant associations identified in OSs failed to be replicated in RCTs. Associations of high credibility from RCTs were in line with current guidelines. Given the heterogeneity of CKD, it seems hard to assume mortality reductions based on findings from OSs.

AB - Patients with chronic kidney disease (CKD) have altered physiologic processes, which result in different treatment outcomes compared with the general population. We aimed to systematically evaluate the efficacy of clinical interventions in reducing mortality of patients with CKD. We searched PubMed, MEDLINE, Embase, and Cochrane Database of Systematic Reviews for meta-analyses of randomized controlled trials (RCT) or observational studies (OS) studying the effect of treatment on all-cause mortality of patients with CKD. The credibility assessment was based on the random-effects summary estimate, heterogeneity, 95% prediction intervals, small study effects, excess significance, and credibility ceilings. Ninety-two articles yielded 130 unique meta-analyses. Convincing evidence from OSs supported mortality reduction with three treatments: angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers for patients not undergoing dialysis, warfarin for patients with atrial fibrillation not undergoing dialysis, and (at short-term) percutaneous coronary intervention compared to coronary artery bypass grafting for dialysis patients. Two treatment comparisons were supported by highly credible evidence from RCTs in terms of all-cause mortality. These were high-flux hemodialysis (HD) versus low-flux HD as a maintenance HD method and statin versus less statin or placebo for patients not undergoing dialysis. Most significant associations identified in OSs failed to be replicated in RCTs. Associations of high credibility from RCTs were in line with current guidelines. Given the heterogeneity of CKD, it seems hard to assume mortality reductions based on findings from OSs.

U2 - 10.3390/jcm9020394

DO - 10.3390/jcm9020394

M3 - SCORING: Journal article

C2 - 32024136

VL - 9

JO - J CLIN MED

JF - J CLIN MED

SN - 2077-0383

IS - 2

ER -