机构:[1]The Second Clinical College, Guangzhou University of Chinese Medicine, China广东省中医院[2]Renal Division, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), China广东省中医院[3]Chronic Disease Management Outpatient, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), China广东省中医院
Background Most patients with chronic kidney disease (CKD) fail to achieve blood pressure (BP) management as recommended. Meanwhile, the effects of promising intervention and telehealth on BP control in CKD patients remain unclear. We aimed to evaluate the efficacy of telehealth for BP in CKD non-dialysis patients. Methods Databases including MEDLINE, EMBASE, CENTRAL, CNKI, Wanfang, VIP and CBM were systematically searched for randomised controlled trials or quasi-randomised controlled trials on telehealth for BP control of CKD3-5 non-dialysis patients. We analysed systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), serum creatinine, and estimated glomerular filtration rate (eGFR) with a fixed-effects model. Results Three studies, with total 680 subjects, were included in our systematic review and two were included for meta-analysis. Pooled estimates showed decreased SBP (pooled mean difference (MD), -5.10; 95% confidence interval (CI), -11.34, 1.14; p > 0.05, p = 0.11), increased DBP (pooled MD, 0.45; 95% CI, -4.24, 5.13; p > 0.05, p = 0.85), decreased serum creatinine (pooled MD, -0.38; 95% CI, -0.83, 0.07; p > 0.05, p = 0.10) and maintained eGFR (pooled MD, 4.72; 95% CI, -1.85, 11.29; p > 0.05, p = 0.16) in the telehealth group. There was no significant difference from the control group. MAP (MD, 0.6; 95% CI, -6.61, 7.81; p > 0.05, p = 0.87) and BP control rate (p > 0.05, p = 0.8), respectively, shown in two studies also demonstrated no statistical significance in the telehealth group. Conclusions There was no statistically significant evidence to support the superiority of telehealth for BP management in CKD patients. This suggests further studies with improved study design and optimised intervention are needed in the future.
基金:
Guangzhou Sci-tech
Programme: Standardisation and Telemedicine System
Construction of Nutrition Therapy in Chronic Kidney Disease
(grant number 2016201604030022), Guangdong Provincial
Department of Science and Technology Programme:
Individualised public medical care service platform with open
source Big Data (grant number 2014B010118005), and Special
Research Project of TCMs by State Administration of
Traditional Chinese Medicine: TCM Integrative treatment for
high risk factors of chronic kidney disease progression: a retrospective
study (grant number 201407001).
第一作者机构:[1]The Second Clinical College, Guangzhou University of Chinese Medicine, China
通讯作者:
通讯机构:[2]Renal Division, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), China[*1]Renal Division, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120 China.
推荐引用方式(GB/T 7714):
Luo Li,Ye Meiqin,Tan Jiaowang,et al.Telehealth for the management of blood pressure in patients with chronic kidney disease: A systematic review[J].JOURNAL OF TELEMEDICINE AND TELECARE.2019,25(2):80-92.doi:10.1177/1357633X17743276.
APA:
Luo, Li,Ye, Meiqin,Tan, Jiaowang,Huang, Qiong,Qin, Xindong...&Wu, Yifan.(2019).Telehealth for the management of blood pressure in patients with chronic kidney disease: A systematic review.JOURNAL OF TELEMEDICINE AND TELECARE,25,(2)
MLA:
Luo, Li,et al."Telehealth for the management of blood pressure in patients with chronic kidney disease: A systematic review".JOURNAL OF TELEMEDICINE AND TELECARE 25..2(2019):80-92