| Objective:To evaluate the effect of vitamin E treatment on antioxidant molecules in dialysis patients.Methods:We searched three databases including PubMed,Embase and Cochrane Library.The retrieval time limit was from inception up to July 25,2022.Subject words and free words were used for retrieval without language restriction.The search terms include"Peritoneal Dialysis","Peritoneal Dialyses","Hemodialysis","Hemodialyses","Antioxidants","Anti-Oxidant","Vitamin E","Tocopherol" and so on.The retrieved literatures were screened according to the inclusion and exclusion criteria,and the outcome indicators were defined as superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GPX)and total antioxidant level.The quality evaluation and data extraction process of the included documents were completed by two researchers.When the opinion of the two researchers is contradictory,the third researcher will make a decision.The software of Review Manager 5.3 was used to present the quality evaluation results of randomized controlled trial(RCT),and STATA 15.0 was used to perform heterogeneity test,subgroup analysis,sensitivity analysis,and publication bias evaluation.Results:A total of 24 experimental studies were included in this study,including 8 RCT studies and 16 non-RCT studies.Fourteen articles were related to the treatment of hemodialysis(HD)patients with vitamin E-coated dialyzer,twelve articles were related to the treatment of HD patients with oral vitamin E,and two articles were related to the treatment of peritoneal dialysis(PD)patients with oral vitamin E.Meta analysis results:Long-term treatment with vitamin E-coated dialyzer can significantly improve the level of antioxidant indexes in blood of HD patients[SMD=0.323,95%CI(0.059,0.587),P=0.016],heterogeneity:I2=62.5%.The levels of erythrocyte derived SOD,CAT and plasma derived total antioxidant level were significantly increased[SMD=0.402,95%CI(0.006,0.797),P=0.047;SMD=0.510,95%CI(0.053,0.967),P=0.029;SMD=0.574,95%CI(0.281,0.867),P<0.001],and the heterogeneity:I2=21.4%,I2=0%,I2=0%.After receiving oral vitamin E for two to six months,HD patients’antioxidant index significantly improved[SMD=1.904,95%CI(0.987,2.821),P<0.001],heterogeneity:I2=95.7%,the erythrocyte derived SOD,GPX,CAT level increased significantly[SMD=3.125,95%CI(1.058,5.191),P=0.003;SMD=2.816,95%CI(2.150,3.482),P<0.001;SMD=1.886,95%CI(0.745,3.026),P=0.001],and the heterogeneity:I2=96.7%,I2=/,I2=89.9%.Oral vitamin E treatment did not significantly affect the antioxidant index of PD patients[SMD=-0.013,95%CI(-0.388,0.361),P=0.945],heterogeneity:I2=0%.Conclusion:Long-term treatment with vitamin E-coated dialyzer in HD patients can significantly improve the antioxidant level of blood,among which the erythrocyte derived SOD,CAT and plasma derived total antioxidant level can be significantly increased;After 2 to 6 months of oral vitamin E preparation intervention,HD patients had significantly greater levels of erythrocyte derived SOD,GPX,and CAT.The therapeutic effect of oral vitamin E is often related to the treatment population,treatment dose,treatment time and other factors.More high-quality literature is still needed to confirm the effect of oral vitamin E on various antioxidant indicators;The combined results of antioxidant indexes of PD patients before and after taking vitamin E orally have no significant difference.However,due to less articles included,the results still need more research to verify. |
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