Effect of Bioimpedance-defined Overhydration Parameters on Mortality and Cardiovascular Events in Patients Undergoing Dialysis: a Systematic Review and Meta-analysis

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2021 Sep 9

PMID 34496645

Citations 15

Authors

Yajie Wang

Zejuan Gu

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the role of bioimpedance-defined overhydration (BI-OH) parameters in predicting the risk of mortality and cardiovascular (CV) events in patients undergoing dialysis.

Methods: We searched multiple electronic databases for studies investigating BI-OH indicators in the prediction of mortality and CV events through 23 May 2020. We assessed the effect of BI-OH indexes using unadjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analysis was used for each outcome.

Results: We included 55 studies with 104,758 patients in the meta-analysis. Extracellular water/total body water (ECW/TBW) >0.4 (HR 5.912, 95% CI: 2.016-17.342), ECW/intracellular water (ICW) for every 0.01 increase (HR 1.041, 95% CI: 1.031-1.051), and OH/ECW >15% (HR 2.722, 95% CI: 2.005-3.439) increased the risk of mortality in patients receiving dialysis. ECW/TBW >0.4 (HR 2.679, 95% CI: 1.345-5.339) and ECW/ICW per increment of 10% (HR 1.032, 95% CI: 1.017-1.047) were associated with an increased risk of CV events in patients undergoing dialysis. A 1-degree increase in phase angle was a protective factor for both mortality (HR 0.676, 95% CI: 0.474-0.879) and CV events (HR 0.736, 95% CI: 0.589-0.920).

Conclusions: BI-OH parameters might be independent predictors for mortality and CV events in patients undergoing dialysis.

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