| Objective:The potential role of bioelectrical impedance analysis(bioelectrical impedance analysis,BIA)has received increasing attention in recent years in assessing dry weight in hemodialysis patients.There have been many previous studies on the evaluation of dry weight in hemodialysis patients by BIA,but the results are inconsistent.The purpose of this study was to investigate the clinical value and the effect of long-term survival benefits of BIA in evaluating dry weight in hemodialysis patients.We decided to conduct a systematic review and meta-analysis to evaluate the benefits of dry weight with BIA in hemodialysis patients.Methods:All randomized controlled trials comparing bioelectrical impedance analysis and clinical assessment methods to evaluate the capacity status of hemodialysis patients was searched in Pubmed,Sino Med,CNKI,Wanfang Data,Embase,VIP,The Cochrane Library by computer,without limiting the language of the literature.The search period is from the time the database was established to December 31,2019.Two researchers selected the literature,extracted the data according to the inclusion and exclusion criteria,evaluated the literature quality according to the evaluation standard of Cochrane systematic evaluation instruction manual 5.1.0,and used Revman5.3 software to carry out statistical analysis of the data.To have an objective evaluation of the clinical and survival benefits when using the biological impedance analysis to assess dry weight on hemodialysis patients.Results: A total of 1375 patients were enrolled in 11 studies.Meta analysis of the current evidence showed that using the biological impedance analysis to assess dry weight on hemodialysis patients did not reduce all-cause mortality[RR=0.93,95%CI=(0.74,1.16),P=0.52],all-cause hospitalization rate[RR=0.90,95%CI=(0.57,1.42),P=0.65],the incidence of cardiovascular events(RR=0.71,95%CI=(0.47,1.06),P=0.09)and the incidence of intradialytic hypotension[RR=0.96,95%CI=(0.91,1.02),P=0.22).But it helps to reduce hemodialysis patients’ systolic blood pressure before dialysis [MD=3.99,95%CI=(6.25,1.73),P=0.0005],left ventricular mass index [MD = 6.42,95% CI=(10.46,2.38),P=0.002)and pulse wave velocity [MD=2.03,95%CI=(3.36,0.69),P=0.003).The Meta analysis of the effect of the experimental group and the control group on the all-cause hospitalization rate and pulse wave velocity showed obvious heterogeneity,and the sensitivity analysis of the Meta analysis results was carried out by eliminating the single literature one by one,and the results showed that the results of the above two indexes were robust.However,due to the limitation of the quantity and quality of the included studies,the above conclusions still need to be verified by more large-sample multi-center clinical trials.Conclusion:Compared with the clinical evaluation method,there is no significant difference on the reduction of all-cause mortality,all-cause hospitalization rate,the incidence of cardiovascular events and intradialytic hypotension when using BIA to the assessment of dry weight in hemodialysis patients.But it can improve the pre-dialysis systolic blood pressure of patients,reduce left ventricular mass index and arterial stiffness,thereby improving the quality of life of patients. |
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