Adequacy of dialysis in Iranian patients undergoing hemodialysis : a systematic review and meta-analysis

Context: Preforming an adequate and effective dialysis is essential to improve patients’ quality of life and decrease the complications of kidney failure. However, evidence around the effectiveness of dialysis among Iranian hemodialysis patients is inconclusive. The present study, therefore, was conducted to evaluate the effectiveness of dialysis patients in Iranian hemodialysis patients using a systematic approach. Evidence Acquisition: In this meta-analysis, the search was performed using the keywords “Adequacy of Dialysis”, and “Hemodialysis Adequacy” in SID, MagIran, ISI/Web of Science, PubMed, and Scopus databases without from inception to July 2018. Considering the heterogeneity of the studies, the data were analyzed using the random effects model and STATA version 14. Results: The mean urea kinetic modeling (Kt/V) and urea reduction ratio (URR) in Iranian patients undergoing hemodialysis were 1.11% (95% CI: 1.03-1.81) and 59.94% (95% CI: 58.33-61.54), respectively. There was no correlation between indices of dialysis adequacy, sample size, mean age of samples and year of publication of articles. However, Kt/V and URR in articles with high methodological quality were higher than those with moderate methodological quality. Conclusion: The mean of adequacy of dialysis indices among Iranian patients is below the standard levels and it is necessary to consider measures to improve dialysis effectiveness