慢性肾脏病患者钾摄入量与死亡率及肾脏病进展的剂量-反应Meta分析
Association between dietary potassium intake and risk of mortality,CKD progression in chronic kidney disease patients:A systematic review and dose-response meta-analysis
冯倩 1朱梦霞 1李淑贤 1齐士坤 1韩晓苇2
作者信息
- 1. 518033 深圳,广州中医药大学第四临床医学院
- 2. 518033 深圳,深圳市中医院中医健康管理部;518033 深圳,深圳市中医院护理部
- 折叠
摘要
目的 系统评价慢性肾脏病(chronic kidney disease,CKD)患者的钾摄入量与死亡率及肾脏病进展的剂量-反应关系.方法 计算机检索PubMed、The Cochrane Library、EMbase、Web of Sci-ence、CNKI、WanFang Data、VIP和CBM数据库,检索关于CKD患者钾摄入量与死亡率、肾脏病进展的研究,检索时限均从建库至2023年8月31日.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R 4.2软件进行Meta分析,采用限制性立方样条函数和广义最小二乘估计方法进行剂量-反应Meta分析.结果 共纳入14项队列研究,包括53 694例患者.线性Meta分析结果显示:钾摄入量与CKD患者死亡风险无显著相关(RR=0.875,95％CI:0.746～1.027,P=0.100).剂量-反应分析结果显示:CKD患者钾摄入量与全因死亡率之间存在L型非线性关系(非线性检验P=0.010);钾摄入量与CKD进展无明显的非线性趋势(非线性检验P=0.226),线性趋势结果显示CKD患者钾摄入量每增加一个单位,CKD进展风险降低21.6％(RR=0.784,95％CI:0.625～0.983,P=0.031).结论 当前证据表明过低的钾摄入量不利于降低CKD患者的死亡与肾脏病进展的风险.受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证.
Abstract
Objective To systematically review the dose-response relationship between dietary potassi-um intake and risk of mortality,CKD progression in chronic kidney disease patients.Methods PubMed,The Cochrane Library,EM-base,Web of Science,CNKI,WanFang Data,VIP and CBM databases were electroni-cally searched to collect studies about dietary potassium intake and risk of mortality,CKD progression in pa-tients with CKD from inception to August 2023.Two reviewers screened literature,extracted data and as-sessed the quality of included studies independently.Meta-analysis was performed by using R4.2,and the dose-response relationship was analyzed by using restricted cubic spline function and generalized least squares estimation.Results A total of 14 studies involving 53694 patients were included.The results of meta-analysis showed that no significant association between potassium intake and mortality in CKD patients(RR=0.875,95％CI:0.746～1.027,P=0.100).Dose-response meta-analysis showed an L-shaped association be-tween potassium intake and mortality in CKD patients(non-linear test P=0.010),while there was no signifi-cant non-linear trend between potassium intake and CKD progression(non-linear test P=0.226).The linear trend results showed that for every unit increase in potassium intake in CKD patients,the risk of CKD progres-sion was reduced by 21.6％(RR=0.784,95％CI:0.625～0.983,P=0.031).Conclusion Current evidence sug-gests that potassium intake in CKD patients should not be excessively restricted.Due to limited quality and quantity of the included studies,more high-quality studies are needed to verify above conclusion.
关键词
钾摄入量/死亡率/慢性肾脏病进展/剂量-反应关系Key words
Dietary potassium intake/Mortality/Chronic kidney disease progression/Dose-response re-lationship引用本文复制引用
出版年
2024
NETL
NSTL
万方数据