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

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  • Tzu-Hsuan Yeh
  • Kuan-Chieh Tu
  • Kuo-Chuan Hung
  • Min-Hsiang Chuang
  • Jui-Yi Chen

Abstract

Background: 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). Methods: 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. Results: 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

Suggested Citation

  • Tzu-Hsuan Yeh & Kuan-Chieh Tu & Kuo-Chuan Hung & Min-Hsiang Chuang & Jui-Yi Chen, 2022. "Impact of type of dialyzable beta-blockers on subsequent risk of mortality in patients receiving dialysis: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 17(12), pages 1-14, December.
    • Handle: RePEc:plo:pone00:0279680
    DOI: 10.1371/journal.pone.0279680
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