Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis
Background & Aims Non-selective β blockers (NSBBs) may negatively influence renal function through decreasing heart rate and cardiac output. This study aimed to systematically investigate their association.Methods PubMed, EMBASE, and Cochrane library databases were searched to identify all relev...
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Taylor & Francis Group
2024-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2305935 |
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| author | Xiangbo Xu Fangbo Gao Ting Wang Zuyao Yang Qingchun Zhao Xingshun Qi |
| author_facet | Xiangbo Xu Fangbo Gao Ting Wang Zuyao Yang Qingchun Zhao Xingshun Qi |
| author_sort | Xiangbo Xu |
| collection | DOAJ |
| description | Background & Aims Non-selective β blockers (NSBBs) may negatively influence renal function through decreasing heart rate and cardiac output. This study aimed to systematically investigate their association.Methods PubMed, EMBASE, and Cochrane library databases were searched to identify all relevant studies evaluating the association of NSBBs with renal dysfunction in cirrhotic patients. Unadjusted and adjusted data were separately extracted. Odds ratios (ORs) and hazard ratios (HRs) were pooled. Subgroup meta-analyses were performed according to the proportions of ascites and Child-Pugh class B/C and the mean model for end-stage liver disease (MELD) score. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.Results Fourteen studies were finally included. Based on unadjusted data, NSBBs significantly increased the risk of developing renal dysfunction (OR = 1.49; p = 0.03), and this association remained significant in subgroup analyses of studies where the proportions of ascites was >70% and Child-Pugh class B/C was 100%. Based on adjusted data with propensity score matching (adjusted OR = 0.61; p = 0.08) and multivariable regression modelling (adjusted HR = 0.86; p = 0.713), NSBBs did not increase the risk of developing renal dysfunction, and this association remained not significant in subgroup analyses of studies where the proportions of ascites was >70% and <70%, the proportion of Child-Pugh class B/C was <100%, and the mean MELD score was <15. The quality of evidence was very low for all meta-analyses.Conclusions NSBBs may not be associated with the development of renal dysfunction in liver cirrhosis. However, more evidence is required to clarify their association in specific populations. |
| format | Article |
| id | doaj-art-514f73845c9143c6beb1970ed2d77ddd |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-514f73845c9143c6beb1970ed2d77ddd2025-02-03T09:56:30ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602024-12-0156110.1080/07853890.2024.2305935Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysisXiangbo Xu0Fangbo Gao1Ting Wang2Zuyao Yang3Qingchun Zhao4Xingshun Qi5Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, ChinaDepartment of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, ChinaDepartment of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, ChinaDivision of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, ChinaDepartment of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, ChinaBackground & Aims Non-selective β blockers (NSBBs) may negatively influence renal function through decreasing heart rate and cardiac output. This study aimed to systematically investigate their association.Methods PubMed, EMBASE, and Cochrane library databases were searched to identify all relevant studies evaluating the association of NSBBs with renal dysfunction in cirrhotic patients. Unadjusted and adjusted data were separately extracted. Odds ratios (ORs) and hazard ratios (HRs) were pooled. Subgroup meta-analyses were performed according to the proportions of ascites and Child-Pugh class B/C and the mean model for end-stage liver disease (MELD) score. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.Results Fourteen studies were finally included. Based on unadjusted data, NSBBs significantly increased the risk of developing renal dysfunction (OR = 1.49; p = 0.03), and this association remained significant in subgroup analyses of studies where the proportions of ascites was >70% and Child-Pugh class B/C was 100%. Based on adjusted data with propensity score matching (adjusted OR = 0.61; p = 0.08) and multivariable regression modelling (adjusted HR = 0.86; p = 0.713), NSBBs did not increase the risk of developing renal dysfunction, and this association remained not significant in subgroup analyses of studies where the proportions of ascites was >70% and <70%, the proportion of Child-Pugh class B/C was <100%, and the mean MELD score was <15. The quality of evidence was very low for all meta-analyses.Conclusions NSBBs may not be associated with the development of renal dysfunction in liver cirrhosis. However, more evidence is required to clarify their association in specific populations.https://www.tandfonline.com/doi/10.1080/07853890.2024.2305935Nonselective β blockerspropranololacute kidney injuryhepatorenal syndromeliver cirrhosis |
| spellingShingle | Xiangbo Xu Fangbo Gao Ting Wang Zuyao Yang Qingchun Zhao Xingshun Qi Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis Annals of Medicine Nonselective β blockers propranolol acute kidney injury hepatorenal syndrome liver cirrhosis |
| title | Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis |
| title_full | Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis |
| title_fullStr | Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis |
| title_full_unstemmed | Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis |
| title_short | Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis |
| title_sort | association of non selective β blockers with the development of renal dysfunction in liver cirrhosis a systematic review and meta analysis |
| topic | Nonselective β blockers propranolol acute kidney injury hepatorenal syndrome liver cirrhosis |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2305935 |
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