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2018 ; 13
(3
): e0192895
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Cardiovascular disease risk factors in chronic kidney disease: A systematic
review and meta-analysis
#MMPMID29561894
Major RW
; Cheng MRI
; Grant RA
; Shantikumar S
; Xu G
; Oozeerally I
; Brunskill NJ
; Gray LJ
PLoS One
2018[]; 13
(3
): e0192895
PMID29561894
show ga
BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is a global health burden
and is independently associated with increased cardiovascular disease risk.
Assessment of cardiovascular risk in the general population using prognostic
models based on routinely collected risk factors is embedded in clinical
practice. In CKD, prognostic models may misrepresent risk due to the interplay of
traditional atherosclerotic and non-traditional risk factors. This systematic
review's aim was to identify routinely collected risk factors for inclusion in a
CKD-specific cardiovascular prognostic model. DESIGN, SETTING, PARTICIPANTS AND
MEASUREMENTS: Systematic review and meta-analysis of observational cohort studies
and randomized controlled trials. Studies identified from MEDLINE and Embase
searches using a pre-defined and registered protocol (PROSPERO
ID-2016:CRD42016036187). The main inclusion criteria were individuals ?18 years
of age with non-endstage CKD. Routinely collected risk factors where
multi-variable adjustment for established cardiovascular risk factors had
occurred were extracted. The primary outcome was fatal and non-fatal
cardiovascular events. RESULTS: The review of 3,232, abstracts identified 29
routinely collected risk factors of which 20 were presented in more than 1
cohort. 21 cohorts were identified in relation to 27,465 individuals and 100,838
person-years. In addition to established traditional general population
cardiovascular risk factors, left ventricular hypertrophy, serum albumin,
phosphate, urate and hemoglobin were all found to be statistically significant in
their association with future cardiovascular events. CONCLUSIONS: These
non-traditional risk factors should be assessed in the development of future
cardiovascular prognostic models for use in individuals with CKD.