Open AccessEffect of bioimpedance-defined overhydration parameters on mortality and cardiovascular events in patients undergoing dialysis: a systematic review and meta-analysis
Author(s) -
Yajie Wang,
Zejuan Gu
Publication year - 2021
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/03000605211031063
Subject(s) - medicine , hazard ratio , dialysis , confidence interval , meta analysis , cardiology , proportional hazards model , extracellular fluid , body water , body weight , extracellular , biology , microbiology and biotechnology
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.