中国维持性血液透析患者透析中低血压发生率的系统评价及Meta分析

    Systematic review and Meta-analysis of intradialytic hypotension incidence in Chinese maintenance hemodialysis patients

    • 摘要:
      目的  对中国维持性血液透析患者透析中低血压(intradialytic hypotension,IDH)的患病率和发生率进行系统评价和Meta分析。
      方法  联合主题词与自由词检索多个数据库,时间范围为从建库至2023年8月1日,筛选出符合纳入标准的研究,使用单组率的Meta分析进行合并。
      结果  共纳入涉及12 263例患者的42篇研究,随机效应下合并后的IDH患病率为35.5%(95%CI:30.6~40.7),I2 = 96.5%,PQ<0.001,PEgger<0.001,PBegger = 0.036;IDH发生率为7.2%(95%CI:3.3~15.1),I2 = 100%,PQ<0.001,PEgger = 0.064,PBegger = 0.393。
      结论  整合中国23年内的文献后发现不同研究使用的定义存在多样性,所报道的IDH发生情况存在较大差异,但不同地区间的区别不明显。中国IDH的患病率约35%,发生率约7%,整体呈现上升趋势,建议在统一的IDH定义下开展更多更高质量的研究。

       

      Abstract:
      Objective To conduct a systematic review and Meta-analysis on the prevalence and incidence of intradialytic hypotension (IDH) among maintenance hemodialysis patients in China.
      Methods A comprehensive search was performed across multiple databases using a combination of MeSH terms and free-text keywords. The cut-off period lasted from database inception until August 1, 2023. Studies fulfilling the inclusion criteria were selected and Meta-analysis of single-group proportions was conducted.
      Results  A total of 42 studies involving 12263 patients were included. The pooled prevalence of IDH under a random-effect model was 35.5%(95%CI: 30.6~40.7) with heterogeneity (I2 = 96.5%, PQ<0.001, PEgger<0.001, PBegger = 0.036). The incidence of IDH was 7.2%(95%CI: 3.3~15.1), with heterogeneity (I2 = 100%, PQ<0.001, PEgger = 0.064, PBegger = 0.393).
      Conclusion  A review of the literature spanning 23 years in China has revealed considerable variability in the definitions of IDH across many studies, leading to significant differences in reported IDH rates. However, no notable differences existed across different regions. The prevalence of IDH in China is approximately 35%, with an incidence of about 7%. Both have showed an upward trend. Future high-quality studies should be conducted with a standardized definition of IDH.

       

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