Impact of type of dialyzable beta-blockers on subsequent risk of mortality in patients receiving dialysis: A systematic review and meta-analysis

Beta-blockers has been reported to improve all-cause mortality and cardiovascular mortality in patients receiving dialysis, but type of beta-blockers (i.e., high vs. low dialyzable) on patient outcomes remains unknown. This study aimed at assessing the outcomes of patients receiving dialyzable beta-...

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Bibliographic Details
Published in:PloS one 2022-12, Vol.17 (12), p.e0279680
Main Authors: Yeh, Tzu-Hsuan, Tu, Kuan-Chieh, Hung, Kuo-Chuan, Chuang, Min-Hsiang, Chen, Jui-Yi
Format: Article
Language:English
Subjects:
Adrenergic beta blockers
Adrenergic beta-Antagonists - adverse effects
Beta blockers
Bias
Biology and Life Sciences
Cardiovascular disease
Cardiovascular diseases
Cause of Death
Comparative analysis
Complications and side effects
Congestive heart failure
Dialysis
Health aspects
Health risks
Heart failure
Heart Failure - chemically induced
Hemodialysis
Humans
Medical research
Medicine and Health Sciences
Medicine, Experimental
Meta-analysis
Mortality
Myocardial Infarction
Observational studies
Patient outcomes
Patients
Peritoneal dialysis
Physical Sciences
Renal Dialysis
Renal failure
Research and Analysis Methods
Risk
Sensitivity analysis
Systematic review
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Summary:Beta-blockers has been reported to improve all-cause mortality and cardiovascular mortality in patients receiving dialysis, but type of beta-blockers (i.e., high vs. low dialyzable) on patient outcomes remains unknown. This study aimed at assessing the outcomes of patients receiving dialyzable beta-blockers (DBBs) compared to those receiving non-dialyzable beta-blockers (NDBBs). We searched the databases including PubMed, Embase, Cochrane, and ClinicalTrials.gov until 28 February 2022 to identify articles investigating the impact of DBBs/NDBBs among patients with renal failure receiving hemodialysis/peritoneal dialysis (HD/PD). The primary outcome was risks of all-cause mortality, while the secondary outcomes included risk of overall major adverse cardiac event (MACE), acute myocardial infarction (AMI) and heart failure (HF). We rated the certainty of evidence (COE) by Cochrane methods and the GRADE approach. Analysis of four observational studies including 75,193 individuals undergoing dialysis in hospital and community settings after a follow-up from 180 days to six years showed an overall all-cause mortality rate of 11.56% (DBBs and NDBBs: 12.32% and 10.7%, respectively) without significant differences in risks of mortality between the two groups [random effect, aHR 0.91 (95% CI, 0.81-1.02), p = 0.11], overall MACE [OR 1.03 (95% CI, 0.78-1.38), p = 0.82], and AMI [OR 1.02 (95% CI, 0.94-1.1), p = 0.66]. Nevertheless, the pooled odds ratio of HF among patients receiving DBBs was lower than those receiving NDBB [random effect, OR 0.87 (95% CI, 0.82-0.93), p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0279680