中国维持性血液透析患者瘙痒的患病率及影响因素：一项荟萃分析

Prevalence and influencing factors of pruritus in maintenance hemodialysis patients in China: a meta-analysis.

作者信息

Li Mengjiao, Jiang Ping, Zhao Xujie, Ning Yuping, Huang Liwen

机构信息

Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.

Shanghai Pudong New District People's Hospital, Shanghai, 200120, China.

出版信息

BMC Nephrol. 2025 May 29;26(1):266. doi: 10.1186/s12882-025-04163-7.

DOI:10.1186/s12882-025-04163-7

PMID:40442691

Abstract

OBJECTIVE

To explore the prevalence and influencing factors of Chronic Kidney Disease-associated Pruritus (CKD-aP) among maintenance hemodialysis (MHD) patients in China through a meta-analysis.

METHODS

A systematic computerized search was conducted across ten databases, including CNKI, VIP, Wanfang, PubMed, Web of Science, and The Cochrane Library, to identify studies on the prevalence and influencing factors of pruritus among Chinese hemodialysis patients up to January 2025. Two independent graduate students conducted literature screening, data extraction, and bias risk assessment for the included studies. Data analysis was performed using Stata 17.0 software.

RESULTS

A comprehensive meta-analysis of 27 studies involving 10,346 participants identified 5,968 cases of CKD-ap among hemodialysis patients, examining 30 potential influencing factors. The meta-analysis revealed that the prevalence of CKD-ap in China was 52%, with 26% of patients experiencing mild CKD-ap, 22% moderate CKD-ap, and 8% severe CKD-ap. Factors associated with an increased risk of CKD-ap included duration of dialysis treatment (OR = 1.51, 95% CI: 1.15-1.88), primary disease (OR = 1.43, 95% CI: 0.87-1.99), dry skin disease (OR = 2.46, 95% CI: 1.74-3.19), phosphorus (OR = 1.18, 95% CI: 0.55-1.81), Ca - P product (OR = 2.18, 95% CI: 1.14-3.22), C - reactive protein (CRP) (OR = 1.14, 95% CI: 0.78-1.51), iPTH (OR = 2.45, 95% CI: 0.81-4.09), β - MG(OR = 2.24, 95% CI: 0.94-3.53), and SCr (OR = 1, 95% CI: 1.001-1.005). Conversely, factors including blood calcium levels (OR = 0.33, 95% CI: 0.31-0.35), dialysis modality (OR = 0.54, 95% CI: 0.23-0.85), and Kt/V (OR = 0.60, 95% CI: 0.24-0.96) were associated with a reduced risk of CKD-ap.

CONCLUSION

This meta-analysis demonstrates a high prevalence of CKD-ap among Chinese MHD patients, underscoring the urgent need for improved awareness, preventive interventions, and management strategies in clinical practice.

CLINICAL TRIAL NUMBER

Not applicable.

TRIAL NUMBER

The study was registered in PROSPERO: No. CRD42024562865.

摘要

目的

通过荟萃分析探讨中国维持性血液透析（MHD）患者中慢性肾脏病相关性瘙痒（CKD-aP）的患病率及影响因素。

方法

通过计算机系统检索包括中国知网（CNKI）、维普资讯（VIP）、万方数据、PubMed、Web of Science和考克兰图书馆在内的10个数据库，以识别截至2025年1月关于中国血液透析患者瘙痒患病率及影响因素的研究。两名独立的研究生对纳入研究进行文献筛选、数据提取和偏倚风险评估。使用Stata 17.0软件进行数据分析。

结果

对涉及10346名参与者的27项研究进行的综合荟萃分析确定了血液透析患者中5968例CKD-aP病例，研究了30个潜在影响因素。荟萃分析显示，中国CKD-aP的患病率为52%，其中26%的患者为轻度CKD-aP，22%为中度CKD-aP，8%为重度CKD-aP。与CKD-aP风险增加相关的因素包括透析治疗时间（OR = 1.51，95%CI：1.15 - 1.88）、原发疾病（OR = 1.43，95%CI：0.87 - 1.99）、皮肤干燥症（OR = 2.46，95%CI：1.74 - 3.19）、磷（OR = 1.18，95%CI：0.55 - 1.81）、钙磷乘积（OR = 2.18，95%CI：1.14 - 3.22）、C反应蛋白（CRP）（OR = 1.14，95%CI：0.78 - 1.51）、全段甲状旁腺激素（iPTH）（OR = 2.45，95%CI：0.81 - 4.09）、β2微球蛋白（β - MG）（OR = 2.24，95%CI：0.94 - 3.53）和血清肌酐（SCr）（OR = 1，95%CI：1.001 - 1.005）。相反，包括血钙水平（OR = 0.33，95%CI：0.31 - 0.35）、透析方式（OR = 0.54，95%CI：0.23 - 0.85）和尿素清除指数（Kt/V）（OR = 0.60，95%CI：0.24 - 0.96）等因素与CKD-aP风险降低相关。