Li Li, Liu Hongli, Zhang Qinglin, Jin Hao, Tao Hui, Chen Hongmei, Zhou Zhongwei
Department of Clinical Laboratory, Binhai County People's Hospital, Binhai, Jiangsu, China.
Department of Clinical Laboratory, Nantong Tumor Hospital, Tumor Hospital Affiliated to Nantong University, Jiangsu, China.
Kidney Med. 2024 Feb 22;6(4):100800. doi: 10.1016/j.xkme.2024.100800. eCollection 2024 Apr.
RATIONALE & OBJECTIVE: Long pentraxin-3 (PTX-3) serves as a biomarker for prognosticating adverse clinical outcomes in individuals with chronic kidney disease (CKD). The objective of the current meta-analysis was to evaluate the prognostic efficacy of PTX-3 in patients with CKD. In addition, we compared the prognostic effectiveness of PTX-3 and the short pentraxin C-reactive protein (CRP) in the identical cohort of patients with CKD.
A systematic review and meta-analysis.
SETTING & PARTICIPANTS: Patients with CKD treated with or without dialysis.
A cohort study with a minimum 1-year follow-up.
Risk measurements, adjusted hazard risk with 95% CI, and modified variables.
To aggregate the adjusted effect estimates, a fixed-effects or random-effects model was employed.
Nine studies covering 1,825 patients with CKD were selected in the present review. Six of the 9 studies exclusively included patients receiving hemodialysis. The collected findings indicated that patients with CKD in the highest tertile of PTX-3 demonstrated significantly higher risks of all-cause mortality (HR, 1.92; 95% CI, 1.44-2.56), cardiovascular death (HR, 1.98; 95% CI, 1.28-3.05), infectious death (HR, 5.26; 95% CI, 1.60-17.31), and fatal and nonfatal cardiovascular events (HR, 1.81; 95% CI, 1.35-2.42), as compared with those in the lowest tertile. These significant associations with risk were also observed when effect estimates were presented as per unit change in the PTX-3. Moreover, when comparing the prognostic value of PTX-3 and CRP in the same individuals (5 studies covering 904 patients), PTX-3 proved to be a satisfactory predictor of adverse events in these patients, whereas CRP failed to exhibit such predictive capability, regardless of the type of effect estimate used.
A relatively small sample size and some heterogeneity.
Pentraxin 3 is associated with adverse events in individuals with CKD and may be a more reliable predictor of adverse clinical events than CRP in this population.
长五聚蛋白3（PTX - 3）可作为预测慢性肾脏病（CKD）患者不良临床结局的生物标志物。本荟萃分析的目的是评估PTX - 3在CKD患者中的预后效能。此外，我们还比较了PTX - 3与短五聚蛋白C反应蛋白（CRP）在同一CKD患者队列中的预后效果。
系统评价与荟萃分析。
接受或未接受透析治疗的CKD患者。
一项随访时间至少为1年的队列研究。
风险测量、校正后的风险比及95%置信区间，以及修正变量。
为汇总校正后的效应估计值，采用固定效应模型或随机效应模型。
本综述选取了9项涵盖1825例CKD患者的研究。9项研究中有6项仅纳入了接受血液透析的患者。收集到的研究结果表明，PTX - 3处于最高三分位数的CKD患者发生全因死亡（风险比[HR]，1.92；95%置信区间[CI]，1.44 - 2.56）、心血管死亡（HR，1.98；95% CI，1.28 - 3.05）、感染性死亡（HR，5.26；95% CI，1.60 - 17.31）以及致命和非致命心血管事件（HR，1.81；95% CI，1.35 - 2.42）的风险显著高于最低三分位数的患者。当效应估计值以PTX - 3的单位变化表示时，也观察到了这些与风险的显著关联。此外，在比较PTX - 3和CRP在同一患者（5项研究，涵盖904例患者）中的预后价值时，无论使用何种效应估计类型，PTX - 3都被证明是这些患者不良事件的良好预测指标，而CRP则未表现出这种预测能力。
样本量相对较小且存在一些异质性。
五聚蛋白3与CKD患者的不良事件相关，在该人群中可能是比CRP更可靠的不良临床事件预测指标。
