Cholesterol-Lowering Treatment in Chronic Kidney Disease: Multistage Pairwise and Network Meta-Analyses

Herrera‐Gómez, Francisco; Chimeno, M. Montserrat; Martín-García, Débora; Caparó, Frank Lizaraso; Maurtua-Briseño-Meiggs, Álvaro; Grande-Villoria, Jesús; Bustamante‐Munguira, Juan; Alamartine, Éric; Vilardell, M; Ochoa-Sangrador, Carlos; Álvarez, Francisco

doi:10.1038/s41598-019-45431-5

Cited by 20 publications

(16 citation statements)

References 60 publications

(83 reference statements)

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“…Previous studies in paired and network meta-analyses on the relationship between the efficacy of statin use with or without ezetimibe and the reduction of low-density lipoprotein cholesterol (LDLc) and C-reactive protein (CRP) in patients with chronic kidney disease (CKD) are presented. Evaluation of the benefits of the drug can lead to individual therapy for CKD patients: Lowering cholesterol for CKD patients with high LDLc and CRP levels is recommended (15). Moreover, other previous study found that both hypercholesterolemia and low highdensity lipoprotein cholesterol (HDL-C) were independently associated with albuminuria (OR = 1.49, 95% CI 1.08 -2.07 and OR= 1.53, 95% CI 1.13 -2.09, respectively) (16).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Disease and Chronic Kidney Disease among Women in Indonesia: A Cross-Sectional Population-Based Survey

Wahyuni¹,

Lianawati²,

Harianto³

et al. 2020

Electron J Gen Med

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These study aims were to determine the prevalence and the associated factors of chronic kidney disease among women in Indonesia. Methodology: This cross-sectional study used the data from the Indonesia Family Life Survey wave 5 (IFLS-5) during year 2014 to 2015. This cross-sectional national population survey used a multistage stratified random sampling to select the respondents to response to a structured questionnaire interview, laboratory test and anthropometric measurements. 14,141 women passed the inclusion criteria for the analysis. Multivariable logistic regression was used to determine the association. The average age of the respondents involved in this research was 37.40 years old. Results: Only a small percentage of 1.07 percent of respondents noticed the prevalence of chronic kidney disease. There were 151 out of 14,141 respondents reported the presence of CKD. The final model of a multiple logistic regression indicated that cardiovascular and cholesterol were significantly associated with the Chronic Kidney Disease (CKD) among women in Indonesia. Other significant covariate factors were age (above 50 years old), overweight or obesity and smoking. Conclusion: Metabolic factors include cardiovascular and cholesterol as well as age, body mass index (BMI), and smoking were associated with CKD among women in Indonesia.

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Section: Discussionmentioning

confidence: 99%

Metabolic Disease and Chronic Kidney Disease among Women in Indonesia: A Cross-Sectional Population-Based Survey

Wahyuni¹,

Lianawati²,

Harianto³

et al. 2020

Electron J Gen Med

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“…After assessing study quality [20], and before applying planned contextualization techniques [21][22][23], pairwise and network meta-analyses of cardiac-and noncardiac-surgery-patient aggregate-level data were performed. The overall odds ratio (OR) and 95% confidence interval (CI) were obtained for various postoperative outcomes corresponding to the use of NIRS monitoring (POCD/POD, MACEs, AKI, bleeding/need for transfusion, and mortality) by the Mantel-Haenszel random-effects method.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional pairwise meta-analysis is insufficient when many options for tools (interventions) exist (e.g., when several drugs are available for the same treatment strategy). Network meta-analysis provides a viable solution, even though some interventions/exposures have never been compared head to head in RCTs [21]. Furthermore, to the best of our knowledge, this is the first contemporary review of NIRS monitoring in both types of major procedures.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Near-Infrared Spectroscopy Monitoring in Cardiac and Noncardiac Surgery: Pairwise and Network Meta-Analyses

Ortega-Loubón

Herrera‐Gómez

Bernuy-Guevara

et al. 2019

JCM

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Goal-directed therapy based on brain-oxygen saturation (bSo2) is controversial and hotly debated. While meta-analyses of aggregated data have shown no clinical benefit for brain near-infrared spectroscopy (NIRS)-based interventions after cardiac surgery, no network meta-analyses involving both major cardiac and noncardiac procedures have yet been undertaken. Randomized controlled trials involving NIRS monitoring in both major cardiac and noncardiac surgery were included. Aggregate-level data summary estimates of critical outcomes (postoperative cognitive decline (POCD)/postoperative delirium (POD), acute kidney injury, cardiovascular events, bleeding/need for transfusion, and postoperative mortality) were obtained. NIRS was only associated with protection against POCD/POD in cardiac surgery patients (pooled odds ratio (OR)/95% confidence interval (CI)/I2/number of studies (n): 0.34/0.14–0.85/75%/7), although a favorable effect was observed in the analysis, including both cardiac and noncardiac procedures. However, the benefit of the use of NIRS monitoring was undetectable in Bayesian network meta-analysis, although maintaining bSo2 > 80% of the baseline appeared to have the most pronounced impact. Evidence was imprecise regarding acute kidney injury, cardiovascular events, bleeding/need for transfusion, and postoperative mortality. There is evidence that brain NIRS-based algorithms are effective in preventing POCD/POD in cardiac surgery, but not in major noncardiac surgery. However, the specific target bSo2 threshold has yet to be determined.

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“…Bayesian network analysis is an extension of traditional meta-analysis, which can make indirect comparisons of two treatments through a common comparator in the absence of head-to-head direct randomized controlled trials (Herrera-Gomez et al, 2019). Therefore, we performed a Bayesian network analysis to evaluate the relative proteinuria reduction and blood pressure changes by various ACEIs or ARBs or their combination for normotensive patients with CKD.…”

Section: Introductionmentioning

confidence: 99%

Comparative proteinuria management of different angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for normotensive patients with CKD: a Bayesian network meta-analysis

Huo

et al. 2020

PeerJ

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Background Both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are blood pressure-lowering agents, but they are also being used to control proteinuria in early chronic kidney disease (CKD) patients. However, clinically, some patients present merely proteinuria without hypertension. No guidelines pointed out how to select treatments for proteinuria in normotensive patients. Thus, we conducted a Bayesian network analysis to evaluate the relative effects of different kinds of ACEI or ARB or their combination on proteinuria and blood pressure reduction. Methods The protocol was registered in PROSPERO with ID CRD42017073721. A comprehensive literature database query was carried out systematically according to PICOS strategies. The primary outcome was reduction in proteinuria, and the secondary outcomes were eGFR reduction and blood pressure reduction. Random-effects pairwise and Bayesian network meta-analyses were used to estimate the effect of different regimens. Results A total of 14 RCTs with 1,098 patients were included in the analysis. All treatment strategies of ACEI, ARB or their combination had significantly greater efficacy in reducing proteinuria than placebo in normotensive CKD patients. The combination therapy of olmesartan+temocapril had the highest probability (22%) of being the most effective treatment to reduce proteinuria in normotensive CKD patients. Olmesartan and lisinopril ranked second (12%), and temocapril ranked third (15%) but reduced blood pressure less than placebo. For IgA nephropathy, the combination therapy of olmesartan+temocapril also had the highest probability (43%) of being the best antiproteinuric treatment, while enalapril had the highest probability (58%) of being the best antiproteinuric therapy for diabetic nephropathy. Conclusions The combination therapy of olmesartan plus temocapril appeared to be the most efficacious for reducing proteinuria in normotensive CKD patients and IgA nephropathy, but the clinical application should be balanced against potential harms. Temocapril can be an option when practitioners are searching for more proteinuria reduction but less blood pressure variation. In normotensive diabetic nephropathy, monotherapy with the ACEI enalapril seems to be the most efficacious intervention for reducing albuminuria. Future studies are required to give a more definitive recommendation.

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Cholesterol-Lowering Treatment in Chronic Kidney Disease: Multistage Pairwise and Network Meta-Analyses

Cited by 20 publications

References 60 publications

Metabolic Disease and Chronic Kidney Disease among Women in Indonesia: A Cross-Sectional Population-Based Survey

Metabolic Disease and Chronic Kidney Disease among Women in Indonesia: A Cross-Sectional Population-Based Survey

Near-Infrared Spectroscopy Monitoring in Cardiac and Noncardiac Surgery: Pairwise and Network Meta-Analyses

Comparative proteinuria management of different angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for normotensive patients with CKD: a Bayesian network meta-analysis

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