Hu Xinmiao, Sang Yan, Yang Mei, Chen Xue, Tang Wenjuan
Department of General Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai Department of Nursing, Affiliated Hospital of Nantong University Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong Art College, Nanjing Audit University, Nanjing, Jiangsu, China.
Medicine (Baltimore). 2018 May;97(21):e10633. doi: 10.1097/MD.0000000000010633.
Chronic kidney disease (CKD)-associated pruritus is a common adverse symptom in patients with end-stage renal disease treated by dialysis. Herein, a systematic review and meta-analysis of the prevalence of CKD-associated pruritus among adult dialysis patients was conducted.An electronic search of PubMed, Web of Science, Elsevier, Wanfang, and Chinese National Knowledge Infrastructure databases was conducted from inception to November 23, 2016, and all cross-sectional studies that reported the prevalence of CKD-associated pruritus in dialysis were collected. The pooled prevalence was estimated by random-effects model. Potential publication bias was evaluated by the funnel plot as well as Begg and Egger tests.After rigorous screening, a total of 42 studies conducted on 11,800 patients were included in this study. The overall prevalence of CKD-associated pruritus among adult dialysis patients was 55% (95% confidence interval [CI], 49-61, I = 97.6%), the stratification of which was 55% (95% CI, 45-65, I = 94.7%) in men and 55% (95% CI, 46-65, I = 93.3%) in women. In hemodialysis (HD) patients, the prevalence of CKD-associated pruritus was 55% (95% CI, 49-62, I = 97.9%), while in peritoneal dialysis (PD) patients, it was 56% (95% CI, 44-68, I = 89.9%). The prevalence of CKD-associated pruritus for mean dialysis duration <40 months was 56% (95% CI, 48-63, I = 75.1%), while that for mean dialysis duration ≥40 months was 50% (95% CI, 36-64, I = 99.1%).The prevalence of CKD-associated pruritus is high in HD and PD. The prevalence among adult dialysis patients is comparable between China and foreign countries as well as between females and males. Studies with the similar disease definition and analysis of the effects of risk factors on CKD-associated pruritus are needed.
慢性肾脏病（CKD）相关瘙痒是接受透析治疗的终末期肾病患者常见的不良症状。在此，我们对成年透析患者中CKD相关瘙痒的患病率进行了系统评价和荟萃分析。对PubMed、Web of Science、Elsevier、万方和中国知网数据库进行了从建库至2016年11月23日的电子检索，收集了所有报告透析中CKD相关瘙痒患病率的横断面研究。采用随机效应模型估计合并患病率。通过漏斗图以及Begg和Egger检验评估潜在的发表偏倚。经过严格筛选，本研究共纳入了对11800例患者进行的42项研究。成年透析患者中CKD相关瘙痒的总体患病率为55%（95%置信区间[CI]，49 - 61，I = 97.6%），其中男性为55%（95% CI，45 - 65，I = 94.7%），女性为55%（95% CI，46 - 65，I = 93.3%）。在血液透析（HD）患者中，CKD相关瘙痒的患病率为55%（95% CI，49 - 62，I = 97.9%），而在腹膜透析（PD）患者中为56%（95% CI，44 - 68，I = 89.9%）。平均透析时间<40个月的患者中CKD相关瘙痒的患病率为56%（95% CI，48 - 63，I = 75.1%），而平均透析时间≥40个月的患者中为50%（95% CI，36 - 64，I = 99.1%）。HD和PD中CKD相关瘙痒的患病率较高。成年透析患者中的患病率在国内外以及男女之间相当。需要开展具有相似疾病定义以及分析危险因素对CKD相关瘙痒影响的研究。
