Key result
Shenfu injection improves SBP and reduces intradialytic hypotension versus conventional therapies, despite low-quality evidence.
Why the study?
Does Shenfu injection improve clinical outcomes and blood pressure in patients with intradialytic hypotension?
Meta-Analysis
Does Shenfu injection improve clinical outcomes and blood pressure in patients with intradialytic hypotension?
Shenfu injection may be more effective than conventional therapies for intradialytic hypotension, but current evidence is of low quality and insufficient for clinical recommendation.
Low-quality evidence precludes routine use; larger RCTs needed to confirm benefit in intradialytic hypotension.
Objective. To evaluate the effectiveness and safety of Shenfu injection (SFI) for intradialytic hypotension (IDH). Methods. A systematic review of data sources published as of April 2014 was conducted. These included the Cochrane Central Register of Controlled Trials (2014 issue 4), Pubmed, Embase, CBM, CNKI, VIP, and Wangfang Data. Randomized controlled trials (RCTs) involving SFI for treatment and prevention of IDH were identified. Two researchers independently selected articles, extracted data, assessed quality, and cross checked the results. Revman 5.2 was used to analyze the results. Results. Eight RCTs were included. The meta-analysis indicated that compared with conventional therapies alone, SFI could elevate systolic blood pressure (SBP), increase the clinical effective rate, decrease the incidence of hypotension, increase serum albumin (ALB) levels, and reduce C-reactive protein (CRP) levels without serious adverse effects. GRADE Quality of Evidence. the quality of SBP, the effective rate, ALB, and CRP were low, and hypotension incidence and DBP were very low. Conclusions. SFI is more effective than conventional therapies for prevention and treatment of IDH. However, a clinical recommendation is not warranted due to the small number of studies included and low methodology quality. Multi-center and high-quality RCTs with large sample sizes are needed to provide stronger evidence.
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Mo et al. (2014) conducted a meta-analysis in intradialytic hypotension. Shenfu injection vs. conventional therapies alone was evaluated on systolic blood pressure, clinical effective rate, incidence of hypotension, serum albumin, and C-reactive protein. Shenfu injection improved systolic blood pressure and reduced the incidence of intradialytic hypotension compared to conventional therapies, though evidence quality was low.
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