Publication: The Risks of Incident and Recurrent Clostridium difficile-Associated Diarrhea in Chronic Kidney Disease and End-Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis
Issued Date
2015-10-25
Resource Type
ISSN
15732568
01632116
01632116
Other identifier(s)
2-s2.0-84942191136
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Mahidol University
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SCOPUS
Bibliographic Citation
Digestive Diseases and Sciences. Vol.60, No.10 (2015), 2913-2922
Suggested Citation
Parkpoom Phatharacharukul, Charat Thongprayoon, Wisit Cheungpasitporn, Peter J. Edmonds, Pailin Mahaparn, Jackrapong Bruminhent The Risks of Incident and Recurrent Clostridium difficile-Associated Diarrhea in Chronic Kidney Disease and End-Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis. Digestive Diseases and Sciences. Vol.60, No.10 (2015), 2913-2922. doi:10.1007/s10620-015-3714-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/35358
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Title
The Risks of Incident and Recurrent Clostridium difficile-Associated Diarrhea in Chronic Kidney Disease and End-Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis
Abstract
© 2015, Springer Science+Business Media New York. Background: The objective of this systematic review and meta-analysis was to assess the risks of incident and recurrent Clostridium difficile-associated diarrhea in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) requiring dialysis. Methods: A literature search was performed from inception to February 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risks of C. difficile-associated diarrhea in patients with CKD or ESRD versus those without CKD or ESRD were included. Pooled risk ratios (RRs) and 95 % confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method. Results: Twenty studies (nine case–control, seven cohort, and four cross-sectional studies with 162,218,041 patients) were included in the meta-analysis. Pooled RRs of C. difficile-associated diarrhea in patients with CKD and ESRD were 1.95 (95 % CI 1.81–2.10) and 2.63 (95 % CI 2.04–3.38), respectively. When meta-analysis was limited only to cohort and case–control studies with confounder-adjusted analysis, the pooled RRs of C. difficile-associated diarrhea in patients with CKD and ESRD were 1.89 (95 % CI 1.75–2.05) and 2.50 (95 % CI 1.49–4.17), respectively. The pooled RR of recurrent C. difficile-associated diarrhea in patients with CKD was 2.61 (95 % CI 1.53–4.44). Data on the risk of recurrent C. difficile-associated diarrhea were limited. Conclusion: This meta-analysis demonstrates significantly increased risks of incident and recurrent C. difficile-associated diarrhea in patients with CKD. Furthermore, the magnitude of increased risk of C. difficile-associated diarrhea in ESRD patients is even higher.