Clinical and experimental nephrology · 2025
What is the impact of dialysis on the nutritional status of patients according to sex? A systematic review with meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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de Araújo Bezerra Gleyce Kelly, de Sousa Fernandes Matheus Santos, Santos Gabriela Carvalho Jurema, da Conceição Chaves de Lemos Maria, Cabral Poliana Coelho
Аннотация
BACKGROUND: Chronic kidney disease (CKD) is a progressive, irreversible condition that causes kidney damage and has systemic repercussions. The aim of the present study was to summarize the literature on the clinical and nutritional repercussions of dialysis.
METHODS: Searches were conducted of the PubMed/MEDLINE, Scopus, and Embase databases for relevant articles published up to April 2023. The eligibility criteria were studies published in the English language involving male and female patients between 18 and 80 years of age diagnosed with CKD and undergoing dialysis. No restrictions were imposed regarding year of publication. The outcomes of interest were nutritional and clinical status.
RESULTS: A total of 9.266 records were retrieved, 20 of which were included in the qualitative synthesis and 14 were included in the meta-analysis. The samples ranged from 11 to 601 patients and mean age was 57.6 ± 7.69 years. Time on dialysis ranged from 36 months to 14.48 years. Greater increases in body weight [MD 9.70, CI 7.58-11.82, Z = 8.96, p < 0.0001], arm muscle area [MD 2.36, CI 1.05-3.67, Z = 3.52, p = 0.0004], phase angle [MD0.81, CI0.50-1.12, Z = 5.16, p < 0.00001], creatinine [MD1.93, CI 1.67-2.20, Z = 14.43, p < 0.00001], albumin [MD1.35, CI 0.88-1.82, Z = 5.61, p < 0.00001], urea [MD11.13, CI 4.67-17.59, Z = 3.37, p = 0.0007], and Kt/v [MD-0.97,CI-2.30-0.35, Z = 1.44, p = 0.15] were found in male patients undergoing dialysis compared to female patients. Heterogeneity among the studies ranged from 0 to 85%.
CONCLUSIONS: Dialysis exerts an impact on the nutritional status of patients with CKD, especially men. Therefore, monitoring clinical-nutritional variables is of fundamental importance in this population.
METHODS: Searches were conducted of the PubMed/MEDLINE, Scopus, and Embase databases for relevant articles published up to April 2023. The eligibility criteria were studies published in the English language involving male and female patients between 18 and 80 years of age diagnosed with CKD and undergoing dialysis. No restrictions were imposed regarding year of publication. The outcomes of interest were nutritional and clinical status.
RESULTS: A total of 9.266 records were retrieved, 20 of which were included in the qualitative synthesis and 14 were included in the meta-analysis. The samples ranged from 11 to 601 patients and mean age was 57.6 ± 7.69 years. Time on dialysis ranged from 36 months to 14.48 years. Greater increases in body weight [MD 9.70, CI 7.58-11.82, Z = 8.96, p < 0.0001], arm muscle area [MD 2.36, CI 1.05-3.67, Z = 3.52, p = 0.0004], phase angle [MD0.81, CI0.50-1.12, Z = 5.16, p < 0.00001], creatinine [MD1.93, CI 1.67-2.20, Z = 14.43, p < 0.00001], albumin [MD1.35, CI 0.88-1.82, Z = 5.61, p < 0.00001], urea [MD11.13, CI 4.67-17.59, Z = 3.37, p = 0.0007], and Kt/v [MD-0.97,CI-2.30-0.35, Z = 1.44, p = 0.15] were found in male patients undergoing dialysis compared to female patients. Heterogeneity among the studies ranged from 0 to 85%.
CONCLUSIONS: Dialysis exerts an impact on the nutritional status of patients with CKD, especially men. Therefore, monitoring clinical-nutritional variables is of fundamental importance in this population.