Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Division of General Internal Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
BMJ Open. 2024 Apr 3;14(4):e078485. doi: 10.1136/bmjopen-2023-078485.
In recent decades, all-cause mortality has increased among individuals with chronic kidney disease (CKD), influenced by factors such as aetiology, standards of care and access to kidney replacement therapies (dialysis and transplantation). The recent COVID-19 pandemic also affected mortality over the past few years. Here, we outline the protocol for a systematic review to investigate global temporal trends in all-cause mortality among patients with CKD at any stage from 1990 to current. We also aim to assess temporal trends in the mortality rate associated with the COVID-19 pandemic.
We will conduct a systematic review of studies reporting mortality for patients with CKD following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search electronic databases, national and multiregional kidney registries and grey literature to identify observational studies that reported on mortality associated with any cause for patients with CKD of all ages with any stage of the disease. We will collect data between April and August 2023 to include all studies published from 1990 to August 2023. There will be no language restriction, and clinical trials will be excluded. Primary outcome will be temporal trends in CKD-related mortality. Secondary outcomes include assessing mortality differences before and during the COVID-19 pandemic, exploring causes of death and examining trends across CKD stages, country classifications, income levels and demographics.
A systematic review will analyse existing data from previously published studies and have no direct involvement with patient data. Thus, ethical approval is not required. Our findings will be published in an open-access peer-reviewed journal and presented at scientific conferences.
CRD42023416084.
近几十年来，慢性肾脏病（CKD）患者的全因死亡率有所上升，这受到病因、护理标准以及肾脏替代疗法（透析和移植）可及性等因素的影响。最近的 COVID-19 大流行也影响了过去几年的死亡率。在此，我们概述了一项系统评价的方案，旨在调查 1990 年至今任何阶段 CKD 患者全因死亡率的全球时间趋势。我们还旨在评估与 COVID-19 大流行相关的死亡率的时间趋势。
我们将根据系统评价和荟萃分析的首选报告项目指南，对报告 CKD 患者死亡率的研究进行系统评价。我们将搜索电子数据库、国家和多区域肾脏登记处以及灰色文献，以确定报告任何原因导致任何年龄 CKD 患者全因死亡率的观察性研究。我们将在 2023 年 4 月至 8 月之间收集数据，以纳入所有发表于 1990 年至 2023 年 8 月的研究。本研究无语言限制，且排除临床试验。主要结局为 CKD 相关死亡率的时间趋势。次要结局包括评估 COVID-19 大流行前后的死亡率差异，探索死亡原因，并检查 CKD 各阶段、国家分类、收入水平和人口统计学的趋势。
系统评价将分析来自先前发表研究的现有数据，且与患者数据无直接关系。因此，不需要伦理批准。我们的研究结果将发表在开放获取的同行评议期刊上，并在科学会议上展示。
PROSPERO 注册号：CRD42023416084。
