Peritoneal dialysis: 1 in 5 patients has pulmonary hypertension

  • Li Y & al.
  • Int Urol Nephrol
  • 19 Nov 2018

  • curated by Yael Waknine
  • Clinical Essentials
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Takeaway

  • Results of a meta-analysis show that pulmonary hypertension (PH) affects 1 in 5 patients undergoing peritoneal dialysis.

Why this matters

  • Prior research has focused primarily on PH in hemodialysis; this is the first meta-analysis to quantify prevalence in peritoneal dialysis.

Study design

  • Meta-analysis of 14 observational studies (n=1483) gleaned from PubMed, EMBASE, the Cochrane Collaboration, and reference lists of relevant articles.
  • 5 prospective, 5 retrospective, and 4 cross-sectional studies were included from China (3), Saudi Arabia (2), Turkey (2), Iran (2), Israel (1), and the U.S. (1).
  • Study population ranged from 5 to 618 patients; mean age, 41.7-73.4 years.
  • Funding: None.

Key results

  • Pooled prevalence of PH was 21% (95% CI, 16%-28%) using a random-effects model.
  • Heterogeneity was high (I2=84%; P<.01 potentially driven by region sample size and publication year.>
  • Prevalence was supported in sensitivity analysis; omission of any 1 study changed the estimates between 20% (95% CI, 14%-27%) and 23% (95% CI, 17%-30%).
  • Egger’s test showed no significant bias (P=.287).
  • Across 9 studies with available data, pooled prevalence of PH in hemodialysis was 36% (95% CI, 27%-48%).

Limitations

  • Pulmonary artery systolic pressure measured by echocardiogram.
  • Very small sample size in some studies.

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