Effects And Safety Of Hemodialysis And Hemodialysis Combined With Hemodiafiltration In The Treatment Of Refractory Hypertension In Uremia: A Meta-analysis

Objective To evaluate the efficacy and safety of hemodialysis combined with hemodiafiltration in the treatment of uremic patients with refractory hypertension by System evaluation method.Methods Standard electronic database were searched to retrieve relevant randomized trials comparing hemodialysis with hemodialysis combined with hemodiafiltration,Meta analysis software used for RevMan 5.2.Results A total of 11 RCT patients(a total of 441 patients)were included in the study.(2)blood pressure measurements: HDF group of systolic pressure and diastolic blood pressure compared with HD group,the Meta analysis results is [respectively MD=-51.70,95%CI(-53.81,-49.59),P < 0.00001] and [MD=-18.96,95%CI(-20.20,-17.72),P<0.00001],whlie The differences were statistically significant;(2)laboratory indicators: After dialysis,the Meta analysis of angiotensin,serum creatinine,urea nitrogen,population reactive antibody and renin present respectively[MD=-64.38,95%CI(-71.47,-57.29),P<0.00001]?[MD=-5.36,95%CI(-34.73,-24.02),P=0.72] ? [MD=0.14,95%CI(-2.32,2.60),P=0.91] ? [MD=-1.09,95%CI(-1.19,-1.00),P<0.00001]?[MD=-0.32,95%CI(-0.38,-0.27),P<0.00001],while there is significant diffrence the levels of angiotensin,renin and group reaction after therapy of HDF,and there are no significant diffrence between HDF and HD in serum creatinine and urea nitrogen clearance;(3)safety evaluation:The HDF group for the complications after tertments such as fever,headache,muscle spasms,angina pectoris,arrhythmia and nausea and vomiting comparing with HD group owns an obviously smaller incidence rate[OR=0.12,95%CI(0.06,0.21),P<0.00001].Conclusions Compared with conventional hemodialysis,a united application of hemodialysis and hemodiafiltration treating patients with uremia and refractory hypertension,no matter in measurement of systolic blood pressure and diastolic blood pressure and hematology indexes such as rennin and angiotensin,can show arelatively satisfactory results,to achieve effective decompression.