Anticoagulant-related nephropathy : systematic review and meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/205317 |
Resumo: | Background. The aim of this study was to report the prevalence and mortality associated with anticoagulant-related nephropathy (ARN) through a systematic review of the literature. Methods. Electronic searches were conducted in the Medline and EMBASE databases, and manual searches were performed in the reference lists of the identified studies. The studies were selected by two independent researchers, first by evaluating the titles and abstracts and then by reading the complete texts of the identified studies. Case series, cross-sectional studies, cohort studies and case–control studies reporting the prevalence and factors associated with ARN were selected. The methodological quality was assessed using the Newcastle–Ottawa scale. Meta-analyses of the prevalence of ARN and 5-year mortality using the random effects model were performed when possible. Heterogeneity was assessed using the I 2 statistic. Results. Five studies were included. Prevalence of ARN ranged from 19% to 63% among the four included cohort studies. Meta-analysis of these resulted in high heterogeneity [I 2 96%, summary effect 31%; 95% confidence interval (CI) 22–42%]. Subgroup meta-analysis yielded an ARN prevalence of 20% among studies that included patients with fewer comorbidities (I 2 12%; 95% CI 19–22%). In a direct comparison, meta-analysis of the 5-year mortality rate between anticoagulated patients who had experienced ARN and anticoagulated patients without ARN, patients with ARN were 91% more likely to die (risk ratio ¼ 1.91; 95% CI 1.22–3; I 2 87%). Risk factors for ARN that were reported in the literature included initial excessive anticoagulation, chronic kidney disease, age, diabetes, hypertension, cardiovascular disease and heart failure. Conclusions. ARN studies are scarce and heterogeneous, and present significant methodological limitations. The high prevalence of ARN reported herein suggests that this entity is underdiagnosed in clinical practice. Mortality in patients with ARN seems to be high compared with patients without this condition in observational studies. |
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Moura, Karolinny Borinelli de AquinoBehrens, Paula Marques PratesPirolli, RafaelaSauer, Aimée BianchessiSandoval, Dayana Esther MelamedVeronese, Francisco José VeríssimoSilva, André Luis Ferreira da2020-02-01T04:14:49Z20192048-8513http://hdl.handle.net/10183/205317001107648Background. The aim of this study was to report the prevalence and mortality associated with anticoagulant-related nephropathy (ARN) through a systematic review of the literature. Methods. Electronic searches were conducted in the Medline and EMBASE databases, and manual searches were performed in the reference lists of the identified studies. The studies were selected by two independent researchers, first by evaluating the titles and abstracts and then by reading the complete texts of the identified studies. Case series, cross-sectional studies, cohort studies and case–control studies reporting the prevalence and factors associated with ARN were selected. The methodological quality was assessed using the Newcastle–Ottawa scale. Meta-analyses of the prevalence of ARN and 5-year mortality using the random effects model were performed when possible. Heterogeneity was assessed using the I 2 statistic. Results. Five studies were included. Prevalence of ARN ranged from 19% to 63% among the four included cohort studies. Meta-analysis of these resulted in high heterogeneity [I 2 96%, summary effect 31%; 95% confidence interval (CI) 22–42%]. Subgroup meta-analysis yielded an ARN prevalence of 20% among studies that included patients with fewer comorbidities (I 2 12%; 95% CI 19–22%). In a direct comparison, meta-analysis of the 5-year mortality rate between anticoagulated patients who had experienced ARN and anticoagulated patients without ARN, patients with ARN were 91% more likely to die (risk ratio ¼ 1.91; 95% CI 1.22–3; I 2 87%). Risk factors for ARN that were reported in the literature included initial excessive anticoagulation, chronic kidney disease, age, diabetes, hypertension, cardiovascular disease and heart failure. Conclusions. ARN studies are scarce and heterogeneous, and present significant methodological limitations. The high prevalence of ARN reported herein suggests that this entity is underdiagnosed in clinical practice. Mortality in patients with ARN seems to be high compared with patients without this condition in observational studies.application/pdfengClinical Kidney Journal. Oxford. Vol. 12, no. 3 (2019), p. 400–407HematúriaLesão renal agudaInsuficiência renal crônicaMortalidadePrevalênciaAnticoagulantesVarfarinaRevisão sistemáticaMetanáliseAnticoagulant-related nephropathyMeta-analysisSystematic reviewWarfarinWarfarin-related nephropathyAnticoagulant-related nephropathy : systematic review and meta-analysisEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001107648.pdf.txt001107648.pdf.txtExtracted Texttext/plain32931http://www.lume.ufrgs.br/bitstream/10183/205317/2/001107648.pdf.txteb8aa48364c0858a7283bab8bc0e1448MD52ORIGINAL001107648.pdfTexto completo (inglês)application/pdf716021http://www.lume.ufrgs.br/bitstream/10183/205317/1/001107648.pdfda202c906610244d2614ef3df87d3368MD5110183/2053172020-02-02 05:15:07.611219oai:www.lume.ufrgs.br:10183/205317Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2020-02-02T07:15:07Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
title |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
spellingShingle |
Anticoagulant-related nephropathy : systematic review and meta-analysis Moura, Karolinny Borinelli de Aquino Hematúria Lesão renal aguda Insuficiência renal crônica Mortalidade Prevalência Anticoagulantes Varfarina Revisão sistemática Metanálise Anticoagulant-related nephropathy Meta-analysis Systematic review Warfarin Warfarin-related nephropathy |
title_short |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
title_full |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
title_fullStr |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
title_full_unstemmed |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
title_sort |
Anticoagulant-related nephropathy : systematic review and meta-analysis |
author |
Moura, Karolinny Borinelli de Aquino |
author_facet |
Moura, Karolinny Borinelli de Aquino Behrens, Paula Marques Prates Pirolli, Rafaela Sauer, Aimée Bianchessi Sandoval, Dayana Esther Melamed Veronese, Francisco José Veríssimo Silva, André Luis Ferreira da |
author_role |
author |
author2 |
Behrens, Paula Marques Prates Pirolli, Rafaela Sauer, Aimée Bianchessi Sandoval, Dayana Esther Melamed Veronese, Francisco José Veríssimo Silva, André Luis Ferreira da |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Moura, Karolinny Borinelli de Aquino Behrens, Paula Marques Prates Pirolli, Rafaela Sauer, Aimée Bianchessi Sandoval, Dayana Esther Melamed Veronese, Francisco José Veríssimo Silva, André Luis Ferreira da |
dc.subject.por.fl_str_mv |
Hematúria Lesão renal aguda Insuficiência renal crônica Mortalidade Prevalência Anticoagulantes Varfarina Revisão sistemática Metanálise |
topic |
Hematúria Lesão renal aguda Insuficiência renal crônica Mortalidade Prevalência Anticoagulantes Varfarina Revisão sistemática Metanálise Anticoagulant-related nephropathy Meta-analysis Systematic review Warfarin Warfarin-related nephropathy |
dc.subject.eng.fl_str_mv |
Anticoagulant-related nephropathy Meta-analysis Systematic review Warfarin Warfarin-related nephropathy |
description |
Background. The aim of this study was to report the prevalence and mortality associated with anticoagulant-related nephropathy (ARN) through a systematic review of the literature. Methods. Electronic searches were conducted in the Medline and EMBASE databases, and manual searches were performed in the reference lists of the identified studies. The studies were selected by two independent researchers, first by evaluating the titles and abstracts and then by reading the complete texts of the identified studies. Case series, cross-sectional studies, cohort studies and case–control studies reporting the prevalence and factors associated with ARN were selected. The methodological quality was assessed using the Newcastle–Ottawa scale. Meta-analyses of the prevalence of ARN and 5-year mortality using the random effects model were performed when possible. Heterogeneity was assessed using the I 2 statistic. Results. Five studies were included. Prevalence of ARN ranged from 19% to 63% among the four included cohort studies. Meta-analysis of these resulted in high heterogeneity [I 2 96%, summary effect 31%; 95% confidence interval (CI) 22–42%]. Subgroup meta-analysis yielded an ARN prevalence of 20% among studies that included patients with fewer comorbidities (I 2 12%; 95% CI 19–22%). In a direct comparison, meta-analysis of the 5-year mortality rate between anticoagulated patients who had experienced ARN and anticoagulated patients without ARN, patients with ARN were 91% more likely to die (risk ratio ¼ 1.91; 95% CI 1.22–3; I 2 87%). Risk factors for ARN that were reported in the literature included initial excessive anticoagulation, chronic kidney disease, age, diabetes, hypertension, cardiovascular disease and heart failure. Conclusions. ARN studies are scarce and heterogeneous, and present significant methodological limitations. The high prevalence of ARN reported herein suggests that this entity is underdiagnosed in clinical practice. Mortality in patients with ARN seems to be high compared with patients without this condition in observational studies. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
dc.date.accessioned.fl_str_mv |
2020-02-01T04:14:49Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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info:eu-repo/semantics/publishedVersion |
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2048-8513 |
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001107648 |
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http://hdl.handle.net/10183/205317 |
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eng |
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Clinical Kidney Journal. Oxford. Vol. 12, no. 3 (2019), p. 400–407 |
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