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Meta-analysis of high flux hemodialysis for prognosis of maintenance hemodialysis patients

ZHANG Ying-ying, LI Xiao-jun, LIU Feng, LIU Na, JIANG Wei, ZHUANG Shou-gang, QI Hua-lin   

  1. Department of Urology, Shanghai East Hospital, Tongji University, Shanghai 200120, China
  • Online:2014-06-28 Published:2014-06-30
  • Supported by:

    Science and Technology Development Foundation of Pudong New Area, PKJ2011-Y04


Objective To assess the effect of high flux hemodialysis (HFHD) on the clinical prognosis of maintenance hemodialysis (MHD) patients by the metaanalysis. Methods Published studies on the comparisons of HFHD and low-flux hemodialysis (LFHD) of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were retrieved, strictly evaluated by the methodological quality, and analyzed by the mata-synthesis. The effects of HFHD on the survival rate, cardiovascular mortality, and causes of mortality of MHD patients were systematically evaluated. Results A total of 8 studies (3 RCTs and 5 CCTs) were included and 5 015 patients were selected after being analyzed by the mata-synthesis. Results of meta-analysis showed that the difference of mortality of the HFHD group and LFHD group was not statistically significant (RR=0.85, 95%CI:0.71-1.01, P=0.06). Three RCTs showed that HFHD significantly reduced the cardiovascular mortality (RR=0.83, 95%CI:0.71-0.98, P=0.03). Two RCTs that used the same unit for describing the clearance of β2-microglobulin (β2-MG) indicated that HFHD had a better clearance rate of β2-MG (MD=-10.89, 95%CI: -14.89-6.97, P<0.000 1). Conclusion HFHD can improve the clearance rate of β2-MG and reduce the cardiovascular mortality but can not reduce the mortality of MHD patients. HFHD may have good long-term effect for MHD patients with low serum albumin or diabetic nephropathy.

Key words: high flux hemodialysis, survival rate, meta-analysis