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脱水对腹膜透析患者死亡率和技术失败率的影响:系统评价和荟萃分析。

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis.

机构信息

Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China.

Division of Nephrology, The Third People's Hospital of Chengdu, Chengdu, China.

出版信息

Blood Purif. 2018;46(4):350-358. doi: 10.1159/000492148. Epub 2018 Sep 6.

Abstract

BACKGROUND

Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bioimpedance-assessed overhydration is a predictor for mortality and technique failure in PD patients.

METHODS

We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses.

RESULTS

Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality.

CONCLUSION

Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club 'Cappuccino with Claudio Ronco' at https://www.karger.com/Journal/ArticleNews/223997?​sponsor=52.

摘要

背景

腹膜透析(PD)患者中常发生水过多,并可能影响 PD 相关结局。本文旨在系统评估生物电阻抗评估的水过多是否是 PD 患者死亡率和技术失败的预测因素。

方法

我们严格按照系统评价和荟萃分析的首选报告项目进行了关于水过多与 PD 患者预后的队列研究的系统评价和荟萃分析。

结果

符合选择标准的文章有 8 篇,其中 5 篇纳入荟萃分析。荟萃分析结果显示,细胞外液/总体水(ECW/TBW)比值较高的水过多与全因死亡率和技术失败风险显著相关。其他较高的二分水过多指标和连续水过多变量均表明水过多是全因死亡率的显著危险因素。

结论

ECW/TBW 比值较高的水过多可能是 PD 患者全因死亡率和技术失败的独立预测因素。然而,需要更多的研究来证实这一结论。视频期刊俱乐部“克劳迪奥·罗恩科的卡布奇诺”,网址:https://www.karger.com/Journal/ArticleNews/223997?​sponsor=52.

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