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慢性肾脏病患者静脉血栓栓塞的风险因素:系统评价和荟萃分析。

Risk factors for venous thromboembolism in patients with chronic kidney disease: a systematic review and meta-analysis.

机构信息

Renal Department, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.

School of Medicine, Renal Department and Nephrology Institute, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Ren Fail. 2024 Dec;46(2):2431149. doi: 10.1080/0886022X.2024.2431149. Epub 2024 Nov 25.

Abstract

PURPOSE

The objective of this study was to conduct a meta-analysis and systematic review to identify the risk factors contributing to thromboembolism (VTE) in chronic kidney disease (CKD) patients.

METHODS

PubMed, Cochrane Library, Web of Science, and Embase databases were searched from inception to October 2024. Cohort, case-control, and cross-sectional studies examining risk factors for VTE in CKD were included. Quality assessment and data extraction were conducted.

RESULTS

Fourteen studies were analyzed. CKD stage 2 (OR: 1.15, 95% CI: 1.06-1.25,  < .01), CKD stage 3 (OR: 2.28, 95% CI: 1.76-2.95,  < .01), CKD stage 3-4 (OR: 1.57, 95% CI: 1.17-2.1,  < .01), end-stage renal disease (OR: 3.68, 95% CI: 1.02-13.27,  < .01), female (OR: 1.30, 95% CI: 1.15-1.48,  < .01), congestive heart failure (CHF) (OR: 1.26, 95% CI: 1.09-1.46,  < .01), atrial fibrillation (AF) (OR: 1.97, 95% CI: 1.40-2.97,  < .01), coronary artery disease (CAD) (OR: 1.28, 95% CI: 1.05-1.56,  = .01), and systemic lupus erythematosus (SLE) (OR: 3.06, 95% CI: 1.57-5.94,  < .01) were associated with increased risk of VTE. In addition, in sensitivity analyses, hemodialysis increased the risk of VTE compared with peritoneal dialysis (OR: 2.35, 95% CI: 1.34-4.14,  < .01).

CONCLUSIONS

Different CKD stages, female, CHF, AF, CAD, and SLE emerge as significant risk factors for VTE in CKD patients. Additionally, VTE risk can be influenced by dialysis modality and other factors. Physicians should comprehensively assess the risk of VTE in patients with CKD.

摘要

目的

本研究旨在进行荟萃分析和系统评价,以确定导致慢性肾脏病(CKD)患者血栓栓塞(VTE)的风险因素。

方法

从建库到 2024 年 10 月,检索了 PubMed、Cochrane 图书馆、Web of Science 和 Embase 数据库。纳入了评估 CKD 患者 VTE 风险因素的队列、病例对照和横断面研究。进行了质量评估和数据提取。

结果

分析了 14 项研究。CKD 2 期(OR:1.15,95%CI:1.06-1.25,  <  .01)、CKD 3 期(OR:2.28,95%CI:1.76-2.95,  <  .01)、CKD 3-4 期(OR:1.57,95%CI:1.17-2.1,  <  .01)、终末期肾病(OR:3.68,95%CI:1.02-13.27,  <  .01)、女性(OR:1.30,95%CI:1.15-1.48,  <  .01)、充血性心力衰竭(CHF)(OR:1.26,95%CI:1.09-1.46,  <  .01)、心房颤动(AF)(OR:1.97,95%CI:1.40-2.97,  <  .01)、冠状动脉疾病(CAD)(OR:1.28,95%CI:1.05-1.56,  =  .01)和系统性红斑狼疮(SLE)(OR:3.06,95%CI:1.57-5.94,  <  .01)与 VTE 风险增加相关。此外,在敏感性分析中,与腹膜透析相比,血液透析增加了 VTE 的风险(OR:2.35,95%CI:1.34-4.14,  <  .01)。

结论

不同的 CKD 阶段、女性、CHF、AF、CAD 和 SLE 是 CKD 患者 VTE 的显著危险因素。此外,VTE 风险可受到透析方式和其他因素的影响。医生应全面评估 CKD 患者的 VTE 风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0479/11590193/636244c4736e/IRNF_A_2431149_F0001_B.jpg

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