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Background  Drug‐eluting stents ( DES s) and bare metal stents ( BMS s) are both recommended to improve coronary revascularization and to treat coronary artery disease in patients with chronic kidney disease ( CKD ). However, the potential superiority of  DES s over  BMS s for reducing the incidence of long‐term major adverse cardiovascular events and mortality in  CKD  patients has not been established, and the results remain controversial. We aimed to systematically assess and quantify the total weight of evidence regarding the use of  DES s versus  BMS s in  CKD  patients.    Methods and Results  In this systematic review and conventional meta‐analysis, electronic studies published in any language until May 20, 2016, were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials and observational studies comparing outcomes in  CKD  patients with  DES s versus  BMS s and extracted data in a standard form. Pooled odd ratios and 95% CIs were calculated using random‐ and fixed‐effects models. Finally, 38 studies involving 123 396 patients were included. The use of  DES s versus  BMS s was associated with significant reductions in major adverse cardiovascular events (pooled odds ratio 0.75; 95%  CI , 0.64–0.88;  P <0.001), all‐cause mortality (odds ratio 0.81; 95%  CI , 0.73–0.90;  P <0.001), myocardial infarction, target‐lesion revascularization, and target‐vessel revascularization. The superiority of  DES s over  BMS s for improving clinical outcomes was attenuated in randomized controlled trials.    Conclusions  The use of  DES s significantly improves the above outcomes in  CKD  patients. Nevertheless, large‐sized randomized controlled trials are necessary to determine the real effect on  CKD  patients and whether efficacy differs by type of  DES .

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis