期刊
BMJ OPEN
卷 11, 期 9, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-045912
关键词
dialysis; end stage renal failure; hypertension; clinical physiology
This systematic review will investigate the changes in arterial stiffness metrics in patients with kidney failure following hemodialysis, and assess the robustness of these mechanical biomarkers.
Introduction Patients with end-stage renal disease are at higher risk of cardiovascular morbidity and mortality, a risk mediated in part by increased aortic stiffness. Arterial stiffness is assessed at different anatomical locations (central elastic or peripheral muscular arteries) using a variety of mechanical biomarkers. However, little is known on the robustness of each of these mechanical biomarkers following a haemodynamic stress caused by a single haemodialysis (HD) session. Methods and analysis A systematic review has been designed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. A targeted search strategy applicable in key databases (PubMed, Embase, the Cochrane Library, Web of Science and grey literature) is constructed to search articles and reviews from inception to 16 October 2020. Only articles of studies conducted with adults under chronic HD for kidney failure, with repeated measures of arterial stiffness metrics (pulse wave velocity, Augmentation Index, arterial distensibility or stiffness) following a before-and-after design surrounding a HD session will be selected. The screening process, data extraction and assessment of risk bias will be done by two independent pairs of reviewers. Meta-analysis will enable adjustments for potential confounders and subgroup analyses will be performed to discriminate changes in arterial stiffness metrics from elastic, muscular or global arterial territories. Ethics and dissemination This study does not require ethical approval. Findings will be submitted for publication to relevant peer-reviewed journals and will be presented at profession-specific conferences. PROSPERO registration number CRD42020213946.
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