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Li Z, Yang L, Xi Z, Yi W, Zeng X, Ma D, Lei Y. Prediction models for intradialytic hypotension in hemodialysis patients: A protocol for systematic review and critical appraisal. PLoS One 2024; 19:e0310191. [PMID: 39250467 PMCID: PMC11383225 DOI: 10.1371/journal.pone.0310191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024] Open
Abstract
Intradialytic hypotension (IDH) is common in hemodialysis patients and can lead to several complications. Risk factors for IDH include demographic characteristics, comorbidities, dialysis procedure factors, and so on. Clinical studies on predictive models for dialysis-induced hypotension have shown inconsistent results. This systematic review aims to evaluate published prediction models for IDH, analyzing their characteristics, predictors, efficacy, and the methodological quality and applicability. The protocol has been prepared using the Preferred Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) guidelines. The systematic review protocol for IDH prediction in hemodialysis patients has been registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY2023110081, DOI: 10.37766/inplasy2023.11.0081). A comprehensive search across five major databases (PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang) will be conducted for studies on prediction models of IDH among hemodialysis patients. Two researchers will independently screen literature, extract data, and evaluate the bias risk and applicability of included studies using prediction modelling study tools. This systematic review will provide critical insights into the efficacy and quality of reporting of the IDH model in hemodialysis patients. This will guide clinical staff in selecting the most appropriate IDH prediction model and inform future research endeavors in IDH prediction.
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Affiliation(s)
- Zifeng Li
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Yichang Central People’s Hospital, Three Gorges University, Yichang City, Hubei Province, China
| | - Luhuan Yang
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Yichang Hubo Medical Research Institute, Yichang City, Hubei Province, China
| | - Zuyang Xi
- Department of Nursing, the First College of Clinical Medical Science, Yichang Central People’s Hospital, Three Gorges University, Yichang City, Hubei Province, China
| | - Wen Yi
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Yichang Central People’s Hospital, Three Gorges University, Yichang City, Hubei Province, China
| | - Xiaoqian Zeng
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Yichang Central People’s Hospital, Three Gorges University, Yichang City, Hubei Province, China
| | - Dongling Ma
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Yichang Central People’s Hospital, Three Gorges University, Yichang City, Hubei Province, China
| | - Yunhong Lei
- Yichang Hubo Medical Research Institute, Yichang City, Hubei Province, China
- Philippine Women’s University School of Nursing, Manila, Philippines
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Chen W, Wang F, Zhao Y, Zhang L, Chen Z, Dai M. Efficacy and safety of furosemide for prevention of intradialytic hypotension in haemodialysis patients: protocol for a multicentre randomised controlled trial. BMJ Open 2021; 11:e048015. [PMID: 34226226 PMCID: PMC8258570 DOI: 10.1136/bmjopen-2020-048015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Intradialytic hypotension (IDH) is a frequent and serious complication of maintaining haemodialysis (HD) patients and associated with subsequent cardiovascular events and higher mortality. Furosemide is commonly used in non-dialysis chronic kidney disease patients and can effectively manage the volume and blood pressure. However, these agents are often discontinued on initiation of dialysis. Two large observational studies have demonstrated that furosemide can lower the rate of IDH episodes. However, there is still no randomised controlled trial (RCT) to investigate the efficacy and safety of furosemide for prevention of IDH in HD patients. The purpose of this study was to assess the efficacy of furosemide in reducing IDH in HD patients with residual renal function. METHODS AND ANALYSIS A two-arm, parallel, multicente RCT will be conducted at 12 hospitals in China. An estimated sample of 560 HD patients will be recruited. Eligible patients will be randomly assigned to treatment group (patients receive oral furosemide 80 mg/day; after a 2-week treatment, if their urine volume is less than 400 mL/day, the dose of furosemide is adjusted to 160 mg/day) and blank control group via a central randomisation system using 1:1 ratio. The primary outcome is the occurrence of IDH. Outcome assessors and data analysts will be blinded and participants will be asked not to reveal their allocation to assessors. The outcome analyses will be performed both on the intention-to-treat, which includes all patients randomised, and per-protocol population, which includes eligible patients who adhere to the planned treatment and follow-ups. ETHICS AND DISSEMINATION The trial protocol has been approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (2019.385)Results will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2000039724.
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Affiliation(s)
- Wenwen Chen
- Division of Nephrology, Kidney Research Institute, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Fang Wang
- Department of Nephrology, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yuliang Zhao
- Department of Nephrology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Ling Zhang
- Department of Nephrology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Zhiwen Chen
- Department of Nephrology, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Mingjin Dai
- Department of Nephrology, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
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