兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Multidisciplinary care in patients with chronic kidney disease: A systematic review and meta-analysis

2015-10

BACKGROUND: Multidisciplinary care (MDC) was widely used in multiple chronic illnesses but the effectiveness of MDC in patients with chronic kidney disease (CKD) was inconclusive. The aim of this meta-analysis is to estimate the effectiveness of MDC for CKD. METHODS: We searched PubMed, Web of Science, Google Scholar, Cochrane Library, and China Journal Full-text Database for relevant articles published in English or Chinese. Studies investigating MDC and non-MDC in patients with CKD were included. Random effect model was used to compare all-cause mortality, dialysis, risk of temporal catheterization, and hospitalization in the two treatment entities. RESULTS: We analyzed 8853 patients of 18 studies in patients with CKD stages 3-5, aged 63+/-12years. MDC was associated with lower risk of all-cause mortality with an odds ratio (OR) of 0.52 [95% confidence interval (CI): 0.44-0.88, p=0.01], mainly in cohort studies. MDC was associated with a lower risk of starting dialysis (p=0.02) and lower risk of temporal catheterization for dialysis (p<0.01). MDC was not associated with a higher chance of choosing peritoneal dialysis (p=0.18) or a lower chance of hospitalization for dialysis (p=0.13). CONCLUSIONS: Limited evidence from randomized controlled trials is currently available to support the benefit of MDC in patients with CKD. MDC is associated with lower all-cause mortality, lower risk of starting dialysis, and lower risk of temporal catheterization for dialysis in cohort studies. MDC is not associated with a higher chance of choosing peritoneal dialysis or a lower chance of hospitalization for dialysis. More studies are needed to determine the optimal professional that should be included in MDC

研究类型
Meta分析
人群
混合人群
主题
["慢性非传染性疾病","医疗护理"]
作者
Su-Ming Wang;Lien-Cheng Hsiao;I-Wen Ting;Tung-Min Yu;Chih-Chia Liang;Huey-Liang Kuo;Chiz-Tzung Chang;Jiung-Hsiun Liu;Che-Yi Chou;Chiu-Ching Huang
国家
Taiwan, China
关键词
Chronic kidney disease; Dialysis; Meta-analysis; Multidisciplinary care.
来源期刊
Eur J Intern Med .
发布日期
2015-10
相关网址
https://www.healthsystemsevidence.org/articles/62fe6fcbef088708d8e124e8-multidisciplinary-care-in-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis?source=saved_email
DOI
10.1016/j.ejim.2015.07.002
学科领域
Not available