撒哈拉以南非洲国家慢性肾脏病患者贫血及其预测因素：系统评价和荟萃分析。
Anemia and its predictors among chronic kidney disease patients in Sub-Saharan African countries: A systematic review and meta-analysis.
机构信息
Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
出版信息
PLoS One. 2023 Feb 2;18(2):e0280817. doi: 10.1371/journal.pone.0280817. eCollection 2023.
INTRODUCTION
Anemia is a serious complication of chronic kidney disease (CKD) with a significant adverse outcome on the burden and progression of the disease. Hence, the study intended to assess the pooled prevalence of anemia and its predictors among CKD patients in Sub-Saharan African nations.
METHODS
To identify the relevant studies systematic searches were carried out in Medline, EMBASE, HINARI, Google Scholar, Science Direct, and Cochrane Library. From selected studies, data were taken out with a standardized data extraction format prepared in Microsoft Excel. Inverse variance (I2) tests were employed to evaluate the heterogeneity across the included studies. Due to substantial heterogeneity among the studies, a random-effects meta-analysis technique was employed to estimate the pooled prevalence of anemia. Subgroup analysis, sensitivity analysis, and meta-regression analysis were carried out to search the possible bases of heterogeneity. Funnel plot symmetry, Begg's test, and Egger's regression test were employed to assess the existence of publication bias. In addition, factors associated with anemia among CKD patients were examined. All statistical analyses were carried out with STATA™ Version 14 software.
RESULTS
A total of 25 studies with 5042 study participants were considered in this study. The pooled prevalence of anemia among CKD patients was estimated to be 59.15% (95% CI, 50.02-68.27) with a substantial level of heterogeneity as evidenced by I2 statistics (I2 = 98.1%; p < 0.001). Stage of CKD (3-5) (pooled odds ratio (POR) = 5.33, 95% CI:4.20-6.76), presence of diabetes mellitus (POR = 1.75, 95% CI: 1.10-2.78), hemodialysis history (POR = 3.06, 95% CI: 1.63-5.73), and female sex (POR = 2.50, 95% CI: 1.76-3.55) were significantly related with anemia.
CONCLUSIONS
More than half of CKD patients were suffering from anemia. Stage of CKD, presence of DM, hemodialysis history, and being female sex were factors associated with anemia among CKD patients.
简介
贫血是慢性肾脏病（CKD）的严重并发症，对疾病的负担和进展有显著的不良影响。因此，本研究旨在评估撒哈拉以南非洲国家 CKD 患者贫血的总体患病率及其预测因素。
方法
为了确定相关研究，我们在 Medline、EMBASE、HINARI、Google Scholar、Science Direct 和 Cochrane Library 中进行了系统检索。从选定的研究中，使用在 Microsoft Excel 中准备的标准化数据提取格式提取数据。采用方差倒数（I2）检验评估纳入研究之间的异质性。由于研究之间存在显著的异质性，因此采用随机效应荟萃分析技术来估计贫血的总体患病率。进行亚组分析、敏感性分析和荟萃回归分析，以寻找异质性的可能基础。采用漏斗图对称性、贝格检验和埃格检验来评估发表偏倚的存在。此外，还检查了 CKD 患者贫血相关因素。所有统计分析均使用 STATA™ Version 14 软件进行。
结果
本研究共纳入 25 项研究，涉及 5042 名研究参与者。估计 CKD 患者贫血的总体患病率为 59.15%（95% CI，50.02-68.27），异质性水平较高，I2 统计量（I2=98.1%；p<0.001）。CKD 分期（3-5）（合并优势比（POR）=5.33，95% CI：4.20-6.76）、合并糖尿病（POR=1.75，95% CI：1.10-2.78）、血液透析史（POR=3.06，95% CI：1.63-5.73）和女性（POR=2.50，95% CI：1.76-3.55）与贫血显著相关。
结论
超过一半的 CKD 患者患有贫血。CKD 分期、合并糖尿病、血液透析史和女性是 CKD 患者贫血的相关因素。
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