机构:[1]Global Health–Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of ChineseMedicine, Guangzhou, Guangdong Province, China,大德路总院肾内科大德路总院肾内科广东省中医院[3]Department of Emergency, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China,大德路总院急诊科大德路总院急诊科广东省中医院[4]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,[5]Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of ChineseMedicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China,广东省中医院[6]Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden,[7]Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia,[8]Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia,[9]Translational Research Institute, Brisbane, Queensland, Australia and[10]Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
Background. Infections are common and can be fatal in patients undergoing long-term dialysis. Recent studies have shown conflicting evidence associating infection with vitamin D status or use of vitamin D and have not been systematically reviewed in this population. Methods. We searched PubMed, Web of Science, Cochrane Library, Embase and three Chinese databases from inception until December 2017 for interventional [non-randomized or randomized controlled trials (RCTs)], cohort and case-control studies on levels of serum 25-hydroxyvitamin D [25(OH) D] or use of vitamin D [supplemental nutritional vitamin D or vitamin D receptor activator (VDRA)] and infection (any infection, infection-required hospitalization or infection-related death or composite) in long-term dialysis patients. We conducted a meta-analysis on the relative risk (RR) of infection and level of 25(OH) D or use of vitamin D. Results. Of 2440 reports identified, 17 studies met inclusion criteria, all with moderate quality, with 6 cohort studies evaluating 25(OH) D serum concentrations (n = 5714) and 11 (2 RCTs and 9 observational studies) evaluating the use of vitamin D (n = 92 309). The risk of composite infection was 39% lower {relative risk [RR] 0.61 [95% confidence interval (CI) 0.41-0.89]} in the subjects with high or normal levels of 25(OH) D than in those with low levels. When compared with those who did not use vitamin D, the pooled adjusted risk for composite infection was 41% lower in those who used vitamin D [RR 0.59 (95% CI 0.43-0.81)]. Conclusions. High or normal serum levels of 25(OH) D and the use of vitamin D, particularly VDRA, were each associated with a lower risk of composite infection in long-term dialysis patients.
基金:
Ministry of Science and Technology, State Administration of Traditional Chinese Medicine, the People's Republic of China [2013BAI02B04, 201407001-1A]; Guangzhou Science and Technology Project [2016201604030085]; Guangdong Provincial Hospital of Chinese Medicine, China; Department of Public Health Sciences, Karolinska Institutet, Sweden; Foreign Experts Project, Foreign Experts Bureau of Guangdong Province, China [GDT20164400034]; Guangdong Provincial Hospital of Chinese Medcine [2014KT1305]; China Scholarship CouncilChina Scholarship Council [201508440214]; Australian National Health and Medical Research CouncilNational Health and Medical Research Council of Australia; Stockholm County CouncilStockholm County Council; Westman Foundation; Swedish Heart and Lung AssociationSwedish Heart-Lung Foundation; Baxter Healthcare; Martin Rind Foundation
第一作者机构:[1]Global Health–Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of ChineseMedicine, Guangzhou, Guangdong Province, China,
通讯作者:
推荐引用方式(GB/T 7714):
Su Guobin,Liu Zhuangzhu,Qin Xindong,et al.Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: a systematic review and meta-analysis[J].NEPHROLOGY DIALYSIS TRANSPLANTATION.2019,34(1):146-156.doi:10.1093/ndt/gfy216.
APA:
Su, Guobin,Liu, Zhuangzhu,Qin, Xindong,Hong, Xu,Liu, Xusheng...&Lundborg, Cecilia Stalsby.(2019).Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: a systematic review and meta-analysis.NEPHROLOGY DIALYSIS TRANSPLANTATION,34,(1)
MLA:
Su, Guobin,et al."Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: a systematic review and meta-analysis".NEPHROLOGY DIALYSIS TRANSPLANTATION 34..1(2019):146-156