Nutritional vitamin D supplementation and health-related outcomes in hemodialysis patients: a protocol for a systematic review and meta-analysis.
Nutritional vitamin D supplementation and health-related outcomes in hemodialysis patients: a protocol for a systematic review and meta-analysis.
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DOI：
10.1186/s13643-015-0002-x
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发表时间：
2015-02-21
影响因子：
3.7
通讯作者：
Joson T
中科院分区：
文献类型：
--
作者：
Mehrotra A;Leung WY;Joson T
血液透析患者中维生素D缺乏的患病率较高。虽然大多数血液透析患者接受活化维生素D（1，25 [OH] 2D）治疗以预防肾性骨营养不良，但25（OH）2D缺乏症的筛查和治疗的临床实践差异很大。目前尚不清楚在该人群中补充D2或D3的营养维生素D是否能提供超出活化维生素D治疗所提供的额外临床益处。我们将根据系统评价和荟萃分析（PRISMA）指南的首选报告项目，对血液透析患者的营养性维生素D（D2/D3）补充和健康相关结局进行系统评价。主要目的是评估营养性维生素D补充对血液透析患者相关临床结局的影响，如死亡率、心血管事件、感染和骨折。次要结局包括贫血、甲状旁腺功能亢进、药物使用（红细胞刺激剂、活性维生素D）和生活质量。我们将在MEDLINE、Scopus、Web of Science和www.example.com上搜索慢性血液透析患者营养性维生素D补充剂（麦角钙化醇/D2或胆钙化醇/D3）的随机对照试验。将使用科克伦风险评估工具评估合格研究的质量。如果认为合并适当/充分，我们将使用标准技术对上述结局进行荟萃分析。这项系统性综述的结果可能会突出我们对营养性维生素D与终末期肾病相关性的认识差距，从而为将来评估营养性维生素D治疗对血液透析人群影响的临床试验设计提供依据。PROSPERO CRD 42014013931
The prevalence of vitamin D deficiency in hemodialysis patients is high. While most hemodialysis patients are treated with activated vitamin D (1,25[OH]2D) to prevent renal osteodystrophy, clinical practices of the screening and treatment of 25(OH)2D deficiency are highly variable. It is unclear if nutritional vitamin D supplementation with D2 or D3 provides an additional clinical benefit beyond that provided by activated vitamin D treatment in this population. We will conduct a systematic review of nutritional vitamin D (D2/D3) supplementation and health-related outcomes in hemodialysis patients according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary objective is to assess the impact of nutritional vitamin D supplementation on clinical outcomes relevant in hemodialysis patients, such as mortality, cardiovascular events, infections, and fractures. Secondary outcomes will include anemia, hyperparathyroidism, medication use (erythrocyte-stimulating agents, activated vitamin D), and quality of life. We will search MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov for randomized, controlled trials of nutritional vitamin D supplementation (ergocalciferol/D2 or cholecalciferol/D3) in chronic hemodialysis patients. The Cochrane Risk Assessment Tool will be used to assess the quality of eligible studies. We will perform meta-analyses using standard techniques for the outcomes listed above if pooling is deemed appropriate/sufficient. The results of this systematic review may highlight gaps in our knowledge of the relevance of nutritional vitamin D in end-stage renal disease, allowing for the informed design of clinical trials assessing the impact of nutritional vitamin D therapy in the hemodialysis population in the future. PROSPERO CRD42014013931