Evidence map›Paper›PMID 40545494›Full record

SynthesisClinical and experimental nephrology2025

Association between blood pressure and cardiovascular events and mortality in patients on peritoneal dialysis: a systematic review and meta-analysis of observational studies.

Rodrigo Bezerra, Flavio Teles, Wilson Nadruz, Audes D M Feitosa, Jorge A P M Coelho, Daniela Ponce, Roberto Pecoits-Filho, Cibele I S Rodrigues

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Clinical and experimental nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rodrigo BezerraKeizo Asami Institute, Federal University of Pernambuco, Recife, PE, Brazil. rodrigobzrra@gmail.com.ORCID http://orcid.org/0000-0001-9719-3176
Flavio TelesSchool of Medicine, Federal University of Alagoas, Maceió, AL, Brazil.ORCID http://orcid.org/0000-0002-6937-5615
Wilson NadruzDepartment of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.ORCID http://orcid.org/0000-0002-0003-5102
Audes D M FeitosaPronto Socorro Cardiológico de Pernambuco (PROCAPE), University of Pernambuco, Rua dos palmares S/N - Santo Amaro, Recife, PE, Brazil.ORCID http://orcid.org/0000-0002-9983-4720
Jorge A P M CoelhoSchool of Medicine, Federal University of Alagoas, Maceió, AL, Brazil.ORCID http://orcid.org/0000-0002-0021-5963
Daniela PonceBotucatu School of Medicine, University of São Paulo State-UNESP, Botucatu, SP, Brazil.ORCID http://orcid.org/0000-0002-6178-6938
Roberto Pecoits-FilhoSchool of Medicine, Pontifical Catholic University of Parana, Curitiba, PR, Brazil.ORCID http://orcid.org/0000-0002-0255-6710
Cibele I S RodriguesDepartment of Clinics, Faculty of Medical Sciences and Health, Pontifical Catholic University of São Paulo, Sorocaba, SP, Brazil.ORCID http://orcid.org/0000-0001-9490-7997

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association between blood pressure (BP) and adverse outcomes in peritoneal dialysis (PD) remains uncertain. This study aims to address this knowledge gap. MATERIALS AND

methodsWe systematically searched five databases (1964-2025) for observational studies assessing associations between BP and mortality or cardiovascular (CV) outcomes in adults on PD. Risk of bias was evaluated using the Newcastle-Ottawa Scale and ROBINS-I. Meta-analyses were performed using random- or fixed-effects models, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for continuous and categorical BP exposures.

resultsTwenty-four studies comprising 28,016 patients (55% males; hypertension prevalence ranging from 39 to 95%) were included. Higher pulse pressure (PP) was consistently associated with increased all-cause (HR per 10 mmHg: 1.20; 95%CI 1.02-1.40) and CV (HR per 10 mmHg: 1.35; 95%CI 1.16-1.58) mortality. For systolic BP (SBP), no significant association was found when analyzed as a continuous variable. However, predefined thresholds revealed that all-cause mortality was significantly associated with SBP < 120 mmHg (HR: 1.55; 95%CI 1.15-2.11) and with SBP > 140 mmHg (HR: 1.18; 95%CI 1.07-1.31). Diastolic BP was not significantly associated with mortality. Additional studies linked higher BP to left ventricular hypertrophy and non-fatal CV events.

conclusionIn PD patients, SBP < 120 mmHg and > 140 mmHg are associated with increased all-cause mortality, while elevated PP robustly predicts all-cause and CV mortality. These findings identify SBP and PP as key prognostic markers and potential targets in PD management.

Indexed as

Blood PressureCardiovascular DiseasesHypertensionPeritoneal DialysisFemaleHumansMaleMiddle AgedObservational Studies as TopicBlood pressureMeta-analysisMortalityPeritoneal dialysisSystematic review

Identifiers

PMID40545494

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.