Meta-analysis Of Mortality Risk Factors In Chinese Maintenance Hemodialysis Patients With Uremia

Objective:A meta-analysis was used to systematically evaluate the risk factors for death in Chinese patients with uremia on maintenance hemodialysis.It is expected to find out the risk factors that can clearly increase the mortality rate,guide the early clinical assessment of the risk factors of death of patients,and intervention measures were given in advance in the hope of improving the overall survival rate of maintenance hemodialysis patients in China..Methods:A search was made of any literatures on the risk factors of maintaining dialysis-uremia patients in China from the Chinese Biomedical Literature Database,CNKI,Wanfang Database,VIP Biomedical Literature Database,Cochrane Library,Pub Med and Embase self-built databases up to June 2020.After screening,the data were extracted and a table was established.Rev Man 5.3 evidence-based medicine software was used for analysis,and statistical data,forest plots and funnel plots were generated to represent Meta analysis results and publication bias.Sensitivity analysis was conducted by changing the data model and removing references one by one to verify the stability of the results.Results:1.Age: A total of 17 literatures were included.Meta-analysis results showed that the average age of patients in the MHD death group was higher than that in the survival group.2.Gender: A total of 19 literatures were included.Meta-analysis results showed that gender had no significant correlation with death of MHD patients.3.Weight gain: A total of 6 literatures were included.Meta-analysis results showed that the average weight gain of patients in the MHD death group was greater than that in the survival group.4.Age of dialysis: A total of 12 literatures were included.Meta-analysis results showed that the average age of dialysis in the MHD death group was lower than that in the survival group.5.Blood purification access: A total of 5 articles were included.Meta-analysis results showed that mortality of MHD patients using deep venous catheterization as hemodialysis access was higher than that of patients using arteriovenous internal fistula as hemodialysis access.6.Hemoglobin: A total of 15 literatures were included.Meta-analysis results showed that the average hemoglobin content in the MHD death group was lower than that in the survival group.7.Serum albumin: A total of 21 literatures were included.Meta-analysis results showed that the average serum albumin content in the MHD death group was lower than that in the survival group.8.Cholesterol: A total of 12 literatures were included.Meta-analysis results showed that the average blood cholesterol content in the MHD death group was lower than that in the survival group.9.Triglyceride: A total of 10 studies were included.Meta-analysis showed that triglyceride content had no significant correlation with death events in MHD patients.10.Parathyroid hormone: A total of 9 literatures were included.Meta-analysis results showed that the average parathyroid hormone concentration in the MHD death group was lower than that in the survival group.11.Infection: A total of 4 articles were included.Meta-analysis results showed that the mortality of MHD patients with concurrent infection was higher than that of patients without concurrent infection.12.Cardiovascular diseases: A total of 7 literatures were included,and the Meta-analysis results showed that the mortality rate of MHD patients with underlying cardiovascular diseases was higher than that of patients without cardiovascular diseases.13.Diabetes: A total of 9 literatures were included,and the Meta-analysis results showed that the mortality rate of MHD patients with underlying diabetes was higher than that of patients without diabetes.14.Hypertension: A total of 9 studies were included.Meta-analysis results showed that there was no significant correlation between hypertension and death events in MHD patients.Conclusion:1.Old age,diabetes,cardiovascular disease,infection,hypoparathyroidism,anemia,hypoproteinemia,deep vein catheterization as hemodialysis channel,weight gain,short dialysis time,and low cholesterol are the risk factors for death in MHD patients.2.Hypertriglyceridemia may be a potential risk factor for death in MHD patients.