• Zahra Karimi, Raeisi ShahrakiHadiHAssistant Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran., and Abdollah Mohammadian-Hafshejani.
• M.Sc. of Epidemiology, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.
• Med Clin (Barc). 2024 May 31; 162 (10): e43e51e43-e51.

ObjectiveAnemia 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.MethodThis 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.ResultsOur 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).ConclusionBased 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.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

26 keywords...

hide…