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

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%, P_Q＜0.001, P_Egger＜0.001, P_Begger = 0.036）. The incidence of IDH was 7.2%（95%CI: 3.3～15.1）, with heterogeneity （I² = 100%, P_Q＜0.001, P_Egger = 0.064, P_Begger = 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.