Abstract：
Anemia is a common condition in end-stage renal disease (ESRD) patients. Erythropoiesis-stimulating agents (ESAs) are commonly used to treat anemia in these patients. However, concerns have been raised regarding their potential effects on blood pressure. This systematic review and meta-analysis aim to investigate the relationship between ESAs and changes in systolic and diastolic blood pressure in hemodialysis patients.
This study is a systematic review and meta-analysis based on clinical trial studies published in various databases, including Web of Science, Cochrane Library, Science Direct, PubMed, Embase, Scopus, and Google Scholar, between 1980 and the end of 2022. We evaluated the quality of articles using the Jadad scale checklist and analyzed the data using Stata 15 software.
Our meta-analysis included 34 clinical trial studies. The results showed a significant increase in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the consumption of ESAs compared to before consumption. The mean difference in SBP was 4.84mmHg (95% CI: 2.74-6.94; p-value<0.001) and in DBP was 4.69mmHg (95% CI: 2.67-6.71; p-value<0.001). No publication bias was observed. Our meta-regression analysis showed that sample size, quality assessment score, and geographical location of the study were significant factors related to observed heterogenicity in to mean difference of SBP (p-value≤0.20). For DBP, the sample size, quality assessment score and follow-up duration were significant variables (p-value≤0.20).
Based on the findings of our study, it appears that receiving ESAs is associated with a significant increase in both SBP and DBP in hemodialysis patients, with an increase of about 5mmHg.
This study is a systematic review and meta-analysis based on clinical trial studies published in various databases, including Web of Science, Cochrane Library, Science Direct, PubMed, Embase, Scopus, and Google Scholar, between 1980 and the end of 2022. We evaluated the quality of articles using the Jadad scale checklist and analyzed the data using Stata 15 software.
Our meta-analysis included 34 clinical trial studies. The results showed a significant increase in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the consumption of ESAs compared to before consumption. The mean difference in SBP was 4.84mmHg (95% CI: 2.74-6.94; p-value<0.001) and in DBP was 4.69mmHg (95% CI: 2.67-6.71; p-value<0.001). No publication bias was observed. Our meta-regression analysis showed that sample size, quality assessment score, and geographical location of the study were significant factors related to observed heterogenicity in to mean difference of SBP (p-value≤0.20). For DBP, the sample size, quality assessment score and follow-up duration were significant variables (p-value≤0.20).
Based on the findings of our study, it appears that receiving ESAs is associated with a significant increase in both SBP and DBP in hemodialysis patients, with an increase of about 5mmHg.
摘要：
目的：贫血是终末期肾病（ESRD）患者的常见病。红细胞生成刺激剂(ESAs)通常用于治疗这些患者的贫血。然而,人们对它们对血压的潜在影响表示担忧。本系统评价和荟萃分析旨在探讨血液透析患者ESAs与收缩压和舒张压变化之间的关系。
方法：本研究是基于各种数据库中发表的临床试验研究的系统综述和荟萃分析，包括WebofScience,科克伦图书馆,科学直接，PubMed,Embase,Scopus,和谷歌学者，从1980年到2022年底。我们使用Jadad量表检查表评估文章的质量，并使用Stata15软件分析数据。
结果：我们的荟萃分析包括34项临床试验研究。结果表明，与消费前相比，消费ESA后收缩压（SBP）和舒张压（DBP）均显着增加。SBP的平均差异为4.84mmHg（95％CI：2.74-6.94；p值<0.001），DBP的平均差异为4.69mmHg（95％CI：2.67-6.71；p值<0.001）。未观察到发表偏倚。我们的荟萃回归分析表明，样本量，质量评估得分，和研究的地理位置是与观察到的SBP平均差（p值≤0.20）的异质性有关的重要因素。对于DBP，样本量,质量评估评分和随访时间是显著变量(p值≤0.20).
结论：根据我们的研究结果，似乎接受ESAs与血液透析患者SBP和DBP的显着增加有关，增加约5mmHg。
方法：本研究是基于各种数据库中发表的临床试验研究的系统综述和荟萃分析，包括WebofScience,科克伦图书馆,科学直接，PubMed,Embase,Scopus,和谷歌学者，从1980年到2022年底。我们使用Jadad量表检查表评估文章的质量，并使用Stata15软件分析数据。
结果：我们的荟萃分析包括34项临床试验研究。结果表明，与消费前相比，消费ESA后收缩压（SBP）和舒张压（DBP）均显着增加。SBP的平均差异为4.84mmHg（95％CI：2.74-6.94；p值<0.001），DBP的平均差异为4.69mmHg（95％CI：2.67-6.71；p值<0.001）。未观察到发表偏倚。我们的荟萃回归分析表明，样本量，质量评估得分，和研究的地理位置是与观察到的SBP平均差（p值≤0.20）的异质性有关的重要因素。对于DBP，样本量,质量评估评分和随访时间是显著变量(p值≤0.20).
结论：根据我们的研究结果，似乎接受ESAs与血液透析患者SBP和DBP的显着增加有关，增加约5mmHg。
