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 regarding the effectiveness of dialysis among Iranian patients undergoing hemodialysis is inconclusive. The current study aimed at evaluating the effectiveness of dialysis in Iranian patients undergoing hemodialysis using a systematic approach. Evidence Acquisition: In the current 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 from inception to July 2018. According to the heterogeneity of the studies, the data were analyzed using the random effects model with 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% confidence interval (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 the paper publication. However, Kt/V and URR in articles with high methodological quality were higher than the ones with moderate methodological quality. Conclusions: The mean adequacy of dialysis indices among Iranian patients was below the standard levels and it is necessary to consider measures to improve dialysis efficacy.