Relationship between measured and prescribed dialysate sodium in haemodialysis: a systematic review and meta-analysis.

Autor:	Ng JK; The George Institute for Global Health, UNSW Sydney, Sydney, Australia.; Department of Medicine & Therapeutics, Carol and Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, China., Smyth B; The George Institute for Global Health, UNSW Sydney, Sydney, Australia.; Department of Renal Medicine, St George Hospital, Sydney, Australia., Marshall MR; Department of Medicine, Counties Manukau Health, Auckland, New Zealand.; Faculty of Medical and Health Sciences, School of Medicine, University of Auckland, Auckland, New Zealand., Kang A; The George Institute for Global Health, UNSW Sydney, Sydney, Australia., Pinter J; Renal Division, University Hospital of Würzburg, Würzburg, Germany., Bassi A; THE George Institute for Global Health India, UNSW, New Delhi, India., Krishnasamy R; Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.; Australasian Kidney Trials Network, The University of Queensland, Australia., Rossignol P; University of Lorraine, Inserm 1433 CIC-P CHRU de Nancy, Inserm U1116 and FCRIN INI-CRCT, Nancy, France., Rocco MV; Medical Center Boulevard, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC, USA., Li Z; Laboratory of Renal Disease, Peking University Institute of Nephrology, Key Ministry of Health of China, Beijing, China., Jha V; THE George Institute for Global Health India, UNSW, New Delhi, India.; Manipal Academy of Higher Education, Manipal, India.; The George Institute for Global Health, School of Public Health, Imperial College, London, UK., Hawley CM; Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.; Australasian Kidney Trials Network, The University of Queensland, Australia., Kerr PG; Department of Nephrology, Monash Health and Monash University, Clayton, Victoria, Australia., DI Tanna GL; The George Institute for Global Health, UNSW Sydney, Sydney, Australia., Woodward M; The George Institute for Global Health, UNSW Sydney, Sydney, Australia.; The George Institute for Global Health, School of Public Health, Imperial College, London, UK.; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA., Jardine AM; The George Institute for Global Health, UNSW Sydney, Sydney, Australia.; Department of Renal Medicine, Concord Repatriation General Hospital, Sydney, Australia.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2021 Mar 29; Vol. 36 (4), pp. 695-703.
DOI:	10.1093/ndt/gfaa287
Abstrakt:	Background: Dialysate sodium (DNa) prescription policy differs between haemodialysis (HD) units, and the optimal DNa remains uncertain. We sought to summarize the evidence on the agreement between prescribed and delivered DNa, and whether the relationship varied according to prescribed DNa. Methods: We searched MEDLINE and PubMed from inception to 26 February 2020 for studies reporting measured and prescribed DNa. We analysed results reported in aggregate with random-effects meta-analysis. We analysed results reported by individual sample, using mixed-effects Bland-Altman analysis and linear regression. Pre-specified subgroup analyses included method of sodium measurement, dialysis machine manufacturer and proportioning method. Results: Seven studies, representing 908 dialysate samples from 10 HD facilities (range 16-133 samples), were identified. All but one were single-centre studies. Studies were of low to moderate quality. Overall, there was no statistically significant difference between measured and prescribed DNa {mean difference = 0.73 mmol/L [95% confidence interval (CI) -1.12 to 2.58; P = 0.44]} but variability across studies was substantial (I2 = 99.3%). Among individually reported samples (n = 295), measured DNa was higher than prescribed DNa by 1.96 mmol/L (95% CI 0.23-3.69) and the 95% limits of agreement ranged from -3.97 to 7.88 mmol/L. Regression analysis confirmed a strong relationship between prescribed and measured DNa, with a slope close to 1:1 (β = 1.16, 95% CI 1.06-1.27; P < 0.0001). Conclusions: A limited number of studies suggest that, on average, prescribed and measured DNa are similar. However, between- and within-study differences were large. Further consideration of the precision of delivered DNa is required to inform rational prescribing. (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu