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Prevalence of abdominal artery calcification in dialysis patients with end-stage renal disease: a systematic review and meta-analysis

  • Nephrology - Original Paper
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Abstract

Purpose

To systematically determine the prevalence of abdominal artery calcification (AAC) in dialysis patients with end-stage renal disease (ESRD) and identify reasons for heterogeneity.

Methods

We searched PubMed, EMBASE, and Web of Science from database inception to March 2017. Cross-sectional or cohort (only used baseline data) studies reporting estimates of AAC prevalence in dialysis adult patients with ESRD were included. We performed a random-effects meta-analysis to generate pooled prevalence estimates. Subgroup analyses were used to compare differences within categorical variables (geographic region, AAC detection instruments, dialysis methods, study design, and sample size), and meta-regression analyses to assess the impact of continuous variables (participants’ age, duration of dialysis, and male proportion).

Results

A total of 44 studies with 9883 dialysis patients were included. The pooled prevalence for AAC was 68.5% (95% CI 63–73.9%). Subgroup analyses suggested that AAC prevalence varied significantly by geographical region and AAC detection instruments, not by dialysis methods, study design and sample size. Meta-regression analysis suggested that positive correlations were found between AAC prevalence and the age of participants as well as the male proportion (r = 1.01477, P = 0.002 and r = 2.034413, P = 0.01, respectively), but not with the duration of dialysis (P = 0.576).

Conclusion

The pooled and nearest estimate of AAC prevalence among dialysis patients was as high as 65%. Geographical region, AAC detection instruments, age of participants, and male proportion potentially lead to the high variance of the reported prevalence. Considering the high AAC prevalence, effective treatment for preventing vascular calcification in these patients is badly needed.

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Abbreviations

CKD:

Chronic kidney disease

AAC:

Abdominal artery calcification

ESRD:

End-stage renal disease

CT:

Computed tomography

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Acknowledgements

This research was granted by National Natural Science Foundation of China (No. 81570673). We thank Gao TT from Guan Yue Science and Technology Company who offered technology supports for us. We thank all the researchers of the 44 included studies whose efforts were the foundation of this study.

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Author notes

  1. Zhihui Yao and Congxia Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, Shaanxi, China

    Zhihui Yao, Qiaona Zhang, Shan Ma, Baosong Gui & Chaoyang Duan

  2. Department of Cardiovascular Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, Shaanxi, China

    Zhihui Yao & Congxia Wang

Authors
  1. Zhihui Yao
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  2. Congxia Wang
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  4. Shan Ma
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Contributions

ZY and CD designed the study. CW oversaw its implementation; QZ, ZY, BG, and CD did all review activities, including searches, study selection, data extraction, and quality assessment. SM planned the statistical analysis; QZ did the meta-analysis and interpreted the results. ZY finished the initial draft, and BG and CW revised the manuscript to make it more affluent. All authors reviewed and approved the final manuscript before submission.

Corresponding author

Correspondence to Chaoyang Duan.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Yao, Z., Wang, C., Zhang, Q. et al. Prevalence of abdominal artery calcification in dialysis patients with end-stage renal disease: a systematic review and meta-analysis. Int Urol Nephrol 49, 2061–2069 (2017). https://doi.org/10.1007/s11255-017-1685-9

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