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Pregnancy-associated Plasma Protein A as a Predictor of All-Cause Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease: A Meta-Analysis of Prospective Studies

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Pregnancy-associated Plasma Protein A as a Predictor of All-Cause Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease: A Meta-Analysis of Prospective Studies

Yuehua Li et al. Arch Med Sci.

Abstract

Introduction: The aim of the study was to assess the association of elevated serum pregnancy associated plasma protein A (PAPP-A) and the risk of all-cause mortality, cardiovascular events and mortality due to infection in patients with chronic kidney disease (CKD).

Material and methods: We systematically searched the Medline database up to March 2017. A random effects model was used to pool the relative risks (RRs) and their 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were performed to explore the potential sources of heterogeneity.

Results: Six studies involving 2034 subjects were included. The pooled RRs for the risk of all-cause mortality and cardiovascular events were 1.50 (95% CI: 1.17-1.92), 1.26 (95% CI: 0.95-1.69), respectively. Sensitivity analysis by excluding each individual study showed no influence on the main results. Subgroup analysis showed that age, male proportion, follow-up term, and assay methods were not modifiable factors.

Conclusions: Our study suggests that elevated serum PAPP-A is associated with the risk of all-cause mortality in patients with CKD.

Keywords: all-cause mortality; chronic kidney disease; meta-analysis; pregnancy-associated plasma protein A.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the trial selection process RR – relative risk.
Figure 2
Figure 2
Elevated serum PAPP-A and risk of all-cause mortality, cardiovascular events and mortality due to infection. Meta-analysis of the highest vs. lowest serum PAPP-A for (A) risk of all-cause mortality; (B) risk of cardiovascular events CI – confidence interval, PAPP-A – pregnancy-associated plasma protein A, RR – relative risk.
Figure 3
Figure 3
Begg’s funnel plot (with pseudo 95% CIs) of the studies in the meta-analysis. Studies that reported the elevated serum PAPP-A and the risk of all-cause mortality were plotted with lnRR on the vertical axis and the SEs of the lnRR along the horizontal axis PAPP-A – pregnancy-associated plasma protein A, RR – relative risk, SEs – standard errors.

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References

    1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128. - PubMed
    1. Thompson S, James M, Wiebe N, et al. Cause of death in patients with reduced kidney function. J Am Soc Nephrol. 2015;26:2504–11. - PMC - PubMed
    1. Tonelli M, Muntner P, Lloyd A, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet. 2012;380:807–14. - PubMed
    1. Sud M, Tangri N, Pintilie M, Levey AS, Naimark D. Risk of end-stage renal disease and death after cardiovascular events in chronic kidney disease. Circulation. 2014;130:458–65. - PubMed
    1. Schefold JC, Filippatos G, Hasenfuss G, Anker SD, von Haehling S. Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nat Rev Nephrol. 2016;12:610–23. - PubMed

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