| Autor: |
Thongprayoon C; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA. charat.thongprayoon@gmail.com., Chokesuwattanaskul R; Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand. drronpichaic@gmail.com., Bathini T; Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA. tarunjacobb@gmail.com., Khoury NJ; Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, MI 48202, USA. nadeenj.khoury@gmail.com., Sharma K; Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, USA. drkonika@gmail.com., Ungprasert P; Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. p.ungprasert@gmail.com., Prasitlumkum N; Department of Internal Medicine, University of Hawaii, Honolulu, HI 96822, USA. narutprasitlumkum@gmail.com., Aeddula NR; Division of Nephrology, Department of Medicine, Deaconess Health System, Evansville, IN 47747, USA. dr.anreddy@gmail.com., Watthanasuntorn K; Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, USA. kanramon@gmail.com., Salim SA; Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA. sohail3553@gmail.com., Kaewput W; Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok 10400, Thailand. wisitnephro@gmail.com., Koller FL; Department of Transplant and Hepatobiliary Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA. fkoller@umc.edu., Cheungpasitporn W; Department of Transplant and Hepatobiliary Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA. wcheungpasitporn@gmail.com. |
| Abstrakt: |
This meta-analysis was conducted with the aims to summarize all available evidence on (1) prevalence of pre-existing atrial fibrillation (AF) and/or incidence of AF following kidney transplantation; (2) the outcomes of kidney transplant recipients with AF; and (3) the trends of estimated incidence of AF following kidney transplantation over time. A literature search was conducted utilizing MEDLINE, EMBASE, and the Cochrane Database from inception through March 2018. We included studies that reported (1) prevalence of pre-existing AF or incidence of AF following kidney transplantation or (2) outcomes of kidney transplant recipients with AF. Effect estimates from the individual study were extracted and combined utilizing random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018086192). Eight cohort studies with 137,709 kidney transplant recipients were enrolled. Overall, the pooled estimated prevalence of pre-existing AF in patients undergoing kidney transplantation was 7.0% (95% CI: 5.6⁻8.8%) and pooled estimated incidence of AF following kidney transplantation was 4.9% (95% CI: 1.7⁻13.0%). Meta-regression analyses were performed and showed no significant correlations between year of study and either prevalence of pre-existing AF ( p = 0.93) or post-operative AF after kidney transplantation ( p = 0.16). The pooled odds ratios (OR) of mortality among kidney transplant recipients with AF was 1.86 (3 studies; 95% CI: 1.03⁻3.35). In addition, AF is also associated with death-censored allograft loss (2 studies; OR: 1.55, 95% CI: 1.02⁻2.35) and stroke (3 studies; OR: 2.54, 95% CI: 1.11⁻5.78) among kidney transplant recipients. Despite advances in medicine, incidence of AF following kidney transplant does not seem to decrease over time. In addition, there is a significant association of AF with increased mortality, allograft loss, and stroke after kidney transplantation. |
