代谢性酸中毒(MA)可能在慢性肾脏病(CKD)患者蛋白质能量消耗(PEW)的发病机制中起关键作用。全面综合补充口服碳酸氢钠(SB)对CKD患者人体测量的影响,在PubMed/MEDLINE进行了系统审查,WebofScience,科克伦中部,和谷歌学者,2022年9月之前发表的相关文章。效果大小的汇总统计,非标准化加权平均差(WMD),和95%置信区间(CI)用于比较SB补充对人体测量参数的影响对照组。为了检测可能的异质性来源,我们进行了一系列预先定义的亚组分析.总的来说,有21个治疗组的17项研究,包括2203名参与者(1149例,1054个控件),符合我们的纳入标准,被纳入荟萃分析.补充SB对体重(BW)没有显着影响,中臂肌围(MAMC),CKD患者的瘦体重(LBM)。在总体分析中补充SB后,体重指数(BMI)显着增加(MD:0.59kg/m2,95%CI:0.25至0.93,p=0.001)。在亚组分析中,在≥24周的研究中,LBM增加(MD:1.81kg,95%CI:0.81至2.81)和BMI低于27kg/m2的参与者(MD:1.81mg/L,95%CI:0.81~2.81)。透析前CKD患者补充SB可能导致BMI增加。然而,我们的研究结果不支持补充SB对其他人体测量结局的有益影响.显然需要长期高质量的干预措施来证实这些发现。
Metabolic acidosis (MA) may play a key role in the pathogenesis of protein-energy wasting (PEW) in patients with chronic kidney disease (CKD). To present a comprehensive synthesis of the effect of oral sodium bicarbonate (SB) supplementation on anthropometric measures in patients with CKD, a systematic
review was undertaken in PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar, of relevant articles published prior to September 2022. The summary statistics of effect size, nonstandardized weighted mean difference (WMD), and 95% confidence interval (CI) were used to compare the effects of SB supplementation on anthropometric parameters vs. control group. To detect probable sources of heterogeneity, a series of predefined subgroup analyses were conducted. In total, 17 studies with 21 treatment arms, including 2203 participants (1149 cases, 1054 controls), met our inclusion criteria and were included in the meta-analysis. SB supplementation had no significant effect on body weight (BW), midarm muscle circumference (MAMC), or lean body mass (LBM) in patients with CKD. There was a significant increase in body mass index (BMI) (MD: 0.59 kg/m2, 95% CI: 0.25 to 0.93, p = 0.001) after SB supplementation in the overall analysis. In subgroup analysis, LBM was increased in studies that were ≥ 24-week duration (MD: 1.81 kg, 95% CI: 0.81 to 2.81) and in participants with BMI lower than 27 kg/m2 (MD: 1.81 mg/L, 95% CI: 0.81 to 2.81). SB supplementation may yield increases in BMI in predialysis CKD patients. However, our findings did not support the beneficial effects of SB supplementation on other anthropometric outcomes. There is an evident need for long-term high-quality interventions to confirm these findings.