Efficacy and safety of expanded hemodialysis in hemodialysis patients: a meta-analysis and systematic review

Abstract

Background: Expanded hemodialysis (HDx) is a new dialysis modality, but a systematic review of the clinical effects of using HDx is lacking. This systematic review and meta-analysis aimed to assess the efficacy and safety of HDx for hemodialysis (HD) patients. Methods: PubMed, the Cochrane library, and EMBASE databases were systematically searched for prospective interventional studies comparing the efficacy and safety of HDx with those of high flux HD or HDF in HD patients. Results: Eighteen trials including a total of 853 HD patients were enrolled. HDx increased the reduction ratio (RR) of β2-microglobulin (SMD 6.28%, 95% CI 0.83, 1.73, p =.02), κFLC (SMD 15.86%, 95% CI 6.96, 24.76, p =.0005), and λFLC (SMD 22.42%, 95% CI, 17.95, 26.88, p