Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis: a meta-analysis

  • Weifeng Shang
  • Yuanyuan Li
  • Yali Ren
  • Wei Li
  • HongLan Wei
  • Junwu Dong
Nephrology - Original Paper

Abstract

Purpose

Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis.

Methods

PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias.

Results

Twenty-one observational studies (n = 8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23–42%), with significant heterogeneity between these studies (I2 = 98%, P < 0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP ≥ 35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias.

Conclusions

PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.

Keywords

Pulmonary hypertension Prevalence CKD Meta-analysis 

Abbreviations

CKD

Chronic kidney disease

PH

Pulmonary hypertension

PASP

Pulmonary artery systolic pressure

RHC

Right heart catheterization

TRV

Tricuspid regurgitant velocity

Notes

Author contributions

JD and WS conceived and designed the study. WS, YR, and YL screened the abstract and full text, extracted the data, assessed the studies, and drafted the manuscript. WS, YL, WL, and HW performed the statistical analyses. WS, and JD revised the manuscript. All authors read the manuscript and approved the final version.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

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

Supplementary material

11255_2018_1853_MOESM1_ESM.pdf (161 kb)
Supplementary material 1 (PDF 160 kb)

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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Weifeng Shang
    • 1
  • Yuanyuan Li
    • 2
  • Yali Ren
    • 3
  • Wei Li
    • 1
  • HongLan Wei
    • 1
  • Junwu Dong
    • 1
  1. 1.Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  2. 2.Department of Respiratory Medicine, The Forth Hospital of Wuhan Affiliated with Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  3. 3.Department of Medical Affaires, Liyuan Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China

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