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盐皮质激素受体拮抗剂与透析患者死亡率及心血管效应的关联:一项荟萃分析。

Association of Mineralocorticoid Receptor Antagonists With the Mortality and Cardiovascular Effects in Dialysis Patients: A Meta-analysis.

作者信息

Gou Wen-Jun, Zhou Fa-Wei, Providencia Rui, Wang Bo, Zhang Heng, Hu Shou-Liang, Gao Xiao-Li, Tuo Yan-Hong, Zhang Yong, Li Tian

机构信息

Department of Nephrology, The First Affiliated Hospital of Yangtze University, Jingzhou, China.

Department of Emergency, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.

出版信息

Front Pharmacol. 2022 May 17;13:823530. doi: 10.3389/fphar.2022.823530. eCollection 2022.

Abstract

Whether Mineralocorticoid receptor antagonists (MRA) reduce mortality and cardiovascular effects of dialysis patients remains unclear. A meta-analysis was designed to investigate whether MRA reduce mortality and cardiovascular effects of dialysis patients, with a registration in INPLASY (INPLASY2020120143). The meta-analysis revealed that MRA significantly reduced all-cause mortality (ACM) and cardiovascular mortality (CVM). Patients receiving MRA presented improved left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF), decreased systolic blood pressure (SBP) and diastolic blood pressure (DBP). There was no significant difference in the serum potassium level between the MRA group and the placebo group. MRA vs. control exerts definite survival and cardiovascular benefits in dialysis patients, including reducing all-cause mortality and cardiovascular mortality, LVMI, and arterial blood pressure, and improving LVEF. In terms of safety, MRA did not increase serum potassium levels for dialysis patients with safety. (https://inplasy.com/inplasy-protocol-1239-2/), identifier (INPLASY2020120143).

摘要

盐皮质激素受体拮抗剂(MRA)是否能降低透析患者的死亡率和心血管疾病影响仍不清楚。一项荟萃分析旨在调查MRA是否能降低透析患者的死亡率和心血管疾病影响,该研究已在国际系统评价计划书(INPLASY)注册(注册号:INPLASY2020120143)。荟萃分析显示,MRA可显著降低全因死亡率(ACM)和心血管疾病死亡率(CVM)。接受MRA治疗的患者左心室质量指数(LVMI)和左心室射血分数(LVEF)有所改善,收缩压(SBP)和舒张压(DBP)降低。MRA组和安慰剂组的血清钾水平无显著差异。与对照组相比,MRA对透析患者具有明确的生存和心血管益处,包括降低全因死亡率和心血管疾病死亡率、LVMI以及动脉血压,并改善LVEF。在安全性方面,MRA不会增加透析患者的血清钾水平。(https://inplasy.com/inplasy-protocol-1239-2/),标识符(INPLASY2020120143)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/9152260/4add9edc0715/fphar-13-823530-g001.jpg

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