Background

Abdominal aortic calcification (AAC) has a pretty high incidence in dialysis patients and may be associated with their prognosis. AAC can be assessed by abdominal CT or X-ray. We determined to investigate whether the occurrence of AAC is associated with all-cause mortality and cardiovascular (CV) events in dialysis patients through this meta-analysis and systematic review.

Methods

A comprehensive literature search was conducted using the PubMed, Cochrane library, Embase, Medline databases to collect cohort studies investigating whether AAC is associated with all-cause mortality and CV events of patients, and we also searched gray articles and conferences abstracts. Meta-analysis was performed by STATA software. Pooled results were expressed as hazard ratio (HR) with corresponding 95% confidence intervals (CI). Fixed-effect models were used to pool the HR of each trial.

Results

10 studies (2,724 dialysis patients) were identified. The presence of AAC was associated with increased risk for all-cause mortality among dialysis patients (HR, 2.84; 95% CI, 2.03–3.98; I² = 9.8%; P = 0.354). Meanwhile, there was an association between AAC and increased risk for all CV events (fatal and non-fatal) in patients (HR, 2.04; 95% CI, 1.51–2.76, I² = 44.6%; P = 0.125). 3 studies presented their endpoint as CV mortality, and the pooled HR was 2.46 (95%CI 1.38–4.40; I² = 0.0%; P = 0.952).

There were also 2 studies that reported their primary endpoint as all-cause mortality and CV events, and the pooled HR was 5.72 (95% CI 3.24–10.10; I² = 0.0%; P = 0.453).

Conclusions

Among patients treated with dialysis, AAC is associated with adverse outcomes, including all-cause mortality and CV events (fatal and non-fatal). The abdominal X-ray or CT scan can be used as a useful added method to evaluate the patient’s calcification. This may provide reasonable data for estimating the risk of adverse events in dialysis patients, which is helpful in guiding clinical treatment and improving the prognosis of dialysis patients.

中文翻译：

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腹主动脉钙化可以预测透析患者的全因死亡率和心血管事件：系统评价和荟萃分析

背景

腹主动脉钙化（AAC）在透析患者中​​发生率相当高，可能与其预后相关。AAC 可以通过腹部 CT 或 X 射线评估。我们决定通过这项荟萃分析和系统评价来调查 AAC 的发生是否与透析患者的全因死亡率和心血管 (CV) 事件相关。

方法

使用 PubMed、Cochrane 图书馆、Embase、Medline 数据库进行了全面的文献检索，收集队列研究，调查 AAC 是否与患者的全因死亡率和心血管事件相关，我们还检索了灰色文章和会议摘要。采用STATA软件进行Meta分析。汇总结果表示为风险比 (HR) 和相应的 95% 置信区间 (CI)。使用固定效应模型来汇总每次试验的 HR。

结果

确定了 10 项研究（2,724 名透析患者）。AAC 的存在与透析患者全因死亡风险增加相关（HR，2.84；95% CI，2.03–3.98；I ² = 9.8%；P = 0.354）。同时，AAC 与患者所有 CV 事件（致命和非致命）风险增加之间存在关联（HR，2.04；95% CI，1.51–2.76，I 2 = 44.6%；P = 0.125 ^）。3 项研究将其终点作为 CV 死亡率，汇总 HR 为 2.46 (95%CI 1.38–4.40；I ² = 0.0%；P = 0.952)。

还有 2 项研究报告其主要终点为全因死亡率和心血管事件，汇总 HR 为 5.72（95% CI 3.24–10.10；I ² = 0.0%；P = 0.453）。

结论

在接受透析治疗的患者中，AAC 与不良结局相关，包括全因死亡率和心血管事件（致命和非致命）。腹部X线或CT扫描可作为评估患者钙化情况的有用补充方法。这可能为估计透析患者不良事件的风险提供合理的数据，有助于指导临床治疗和改善透析患者的预后。