Different hemodialysis methods for survival of patients with maintenance hemodialysis: a meta-analysis

作者：Tan, Wenjia; Wang, Qian; Xin, Guangda; Wang, Yixuan; Liu, Feng^*; He, Chengyan^*; Xu, Xiaohua^*

来源：INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, E-CENTURY PUBLISHING CORP, 40 WHITE OAKS LN, MADISON, WI 53711 USA, 4389-4396, 2018.

• Different hemodialysis methods
• maintenance hemodialysis
• survival rate
• meta-analysis

Objective: To compare the effects of low flux hemodialysis (LFHD) and high flux hemodialysis (HFHD) on survival of patients undergoing maintenance hemodialysis (MHD) with a meta-analysis. Methods: Data on randomized controlled trials and prospective controlled ones involving survival of MHD patients by LFHD or HFHD were retrieved from the computer-based databases (CNKI, EM-BACE, Cochrane Library, PubMed, VIP Chinese database, Wanfang database), with the retrieval period ranging from the date of database establishment to November 5th, 2016. The eligible studies were selected according to the pre-specified inclusion and exclusion criteria. After data extraction and quality assessment by independent reviewers, a meta-analysis was conducted using the RevMan5.2 software, with all-cause mortality as the primary outcome and the rate of death from vascular diseases and the rate of death from infection as secondary outcomes. Results: Nine studies involving 8,662 patients were enrolled. The meta-analysis showed significant lower all-cause mortality in the patients with HFHD than those with LFHD (pooled hazard ratio (HR)=0.71, 95% confidence interval (CI): 0.63-0.82; P < 0.001). Analysis on subsets of follow-up < 3 years and > 3 years revealed that all-cause mortality in HFHD patients was evidently lower than that in LFHD patients (P < 0.001). Among all the hemodialysis patients, there were more deaths from cardiovascular diseases than deaths from infection (P=0.005). The rate of death from cardiovascular diseases was markedly higher in the patients with LFHD than those with HFHD (pooled OR=0.79, 95% CI: 0.65-0.96, P=0.02); but there was no statistical difference in the rate of death from infection between patients with LFHD and HFHD (pooled OR=0.90, 95% CI: 0.69-1.18, P=0.45). Conclusion: Scientific application of HFHD in the treatment of MHD patients resulted in a pronounced improvement in survival and a reduction in death from cardiovascular disease in patients.

• 出版日期2018
• 单位吉林大学