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补充ω-3脂肪酸治疗透析慢性肾脏病患者尿毒症瘙痒的效果:一项荟萃分析。

Effect of Omega-3 Fatty Acid Supplementation in the Treatment of Uremic Pruritus among Dialytic Chronic Kidney Disease Patients: A Meta-analysis.

作者信息

Borbe Jan Bendric C, Elvambuena Bryan F, Eugenio Francheska Angelene Dr, Tan Rey Jaime M

机构信息

Department of Medicine, Philippine General Hospital, University of the Philippines Manila.

Division of Nephrology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2024 May 15;58(8):125-131. doi: 10.47895/amp.vi0.7015. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVES

Pruritus is a common and disabling symptom affecting as much as 50-90% of chronic kidney disease (CKD) patients undergoing dialysis. The pruritus experienced by these patients is often resistant to common anti-pruritic agents and has an overall negative impact on quality of life. With its antioxidant property and anti-inflammatory effects, omega-3 fatty acids have been used to alleviate pruritus. The objective of this study is to assess the effect of omega-3 fatty acid supplementation in reducing the severity of pruritus among dialytic CKD patients.

METHODS

Various electronic databases were searched from inception to August 2022. Randomized controlled trials comparing the effect of omega-3 fatty acids versus placebo on the pruritus scores were included. The studies were independently assessed by three reviewers. Revman version 5.4 was used to analyze the data extracted from the studies while heterogeneity was evaluated using Chi and I.

RESULTS

A total of four studies with a population of 166 patients were included in the meta-analysis. The results show an overall beneficial effect of omega-3 fatty acids with a standardized mean difference of -1.40 (CI -1.74 to -1.05, Z=7.95, value <0.00001). With a Chi of 2.91 (=0.41) and I of 0%, there was no significant heterogeneity observed in the pooled analysis.

CONCLUSION

Overall, the results of the meta-analysis support the finding that omega-3 fatty acid supplementation may have a beneficial effect on reducing the severity of pruritus among CKD patients on dialysis.

摘要

背景与目的

瘙痒是一种常见且使人丧失能力的症状,影响着多达50%-90%接受透析的慢性肾脏病(CKD)患者。这些患者经历的瘙痒通常对常见的止痒药物有抵抗性,并且对生活质量有总体负面影响。由于其抗氧化特性和抗炎作用,ω-3脂肪酸已被用于减轻瘙痒。本研究的目的是评估补充ω-3脂肪酸对降低透析CKD患者瘙痒严重程度的效果。

方法

从数据库建立至2022年8月检索了各种电子数据库。纳入比较ω-3脂肪酸与安慰剂对瘙痒评分影响的随机对照试验。由三位 reviewers 独立评估这些研究。使用Revman 5.4版分析从研究中提取的数据,同时使用卡方检验和I²统计量评估异质性。

结果

荟萃分析共纳入四项研究,涉及166名患者。结果显示ω-3脂肪酸具有总体有益效果,标准化平均差为-1.40(可信区间-1.74至-1.05,Z=7.95,P值<0.00001)。卡方值为2.91(P=0.41),I²为0%,在汇总分析中未观察到显著异质性。

结论

总体而言,荟萃分析结果支持以下发现:补充ω-3脂肪酸可能对降低透析CKD患者的瘙痒严重程度有有益作用。

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