Infective Endocarditis and Its Short and Long-Term Prognosis in Hemodialysis Patients: A Systematic Review and Meta-analysis

There are some conclusive evidences on infective endocarditis and its poor prognosis in the background of end-stage renal disease in patients undergoing chronic hemodialysis; however the findings on the risk of infective endocarditis and its long-term prognosis are very diverse, requiring a systematic approach to achieve a global statistic. Our study tried to systematically assess the risk profile as well as short- and long-term prognosis of infective endocarditis among hemodialysis patients. To select our pointed studies, a deeply searching was planned among major articles databases including MEDLINE, Web of Science, SCOPUS, Google Scholar, and Cochrane Central Register of Controlled Trials considering the study keywords. Two high-qualified investigators independently assessed the collected papers. The risk of bias for the studies was also assessed according to the Cochrane's guideline and using the QUADAS-2 tool. In final, 18 articles were eligible for the final analysis. The overall prevalence of infective endocarditis among patients under chronic hemodialysis was estimated to be 2.9% (95% confidence interval [CI]: 2.7%-3.1%). Our assessment revealed an overall in-hospital death rate of 29.5% (95% CI: 26.7%-46.6%) and long-term death rate of 45.6% (95% CI: 41.9%-49.3%) in hemodialysis patients suffering infective endocarditis. Poor prognosis with high early and long-term death rates due to infective endocarditis has expected in the background of chronic hemodialysis emphasizing the necessity for its early management by identifying patients which prone to disease along with continuous cardiac monitoring.