Pentraxin-3 and Outcomes in CKD: A Systematic Review and Meta-analysis

Abstract

Rationale & ObjectiveLong pentraxin-3 (PTX-3) serves as a biomarker for prognosticating adverse clinical outcomes in individuals with chronic kidney disease (CKD). The objective of the current meta-analysis was to evaluate the prognostic efficacy of PTX-3 in patients with CKD. Additionally, we compared the prognostic effectiveness of PTX-3 and the short pentraxin C-reactive protein (CRP) in the identical cohort of CKD patients. Study DesignSystematic review and meta-analysis. Setting & ParticipantsCKD patients with or without dialysis. Selection Criteria for StudiesA cohort study with a minimum 1-year follow-up. Data ExtractionRisk measurements, adjusted hazard risk (HR) with 95% confidence interval (CI), and modified variables. Analytical ApproachTo aggregate the adjusted effect estimates, a fixed-effects or random-effects model was employed. ResultsNine studies covering 1825 CKD patients were selected in the present paper. Six of the 9 studies exclusively included hemodialysis patients. The collected findings indicated that CKD patients in the highest tertile of PTX-3 demonstrated significantly higher risks of all-cause mortality (HR 1.92, 95% CI 1.44-2.56), cardiovascular death (HR 1.98, 95% CI 1.28-3.05), infectious death (HR 5.26, 95% CI 1.60-17.31), and fatal and non-fatal cardiovascular events (HR 1.81, 95% CI 1.35-2.42), as compared to those in the lowest tertile. These significant associations with risk were also observed when effect estimates were presented as per unit change in PTX-3. Moreover, when comparing the prognostic value of PTX-3 and CRP in the same individuals (5 studies covering 904 patients), PTX-3 proved to be a satisfactory predictor of adverse events in these patients, while CRP failed to exhibit such predictive capability, regardless of the type of effect estimate used. LimitationsA relatively small sample size and some heterogeneity. ConclusionsPentraxin 3 is associated with adverse events in individuals with CKD and may be a more reliable predictor of adverse clinical events than CRP in this population.