Evidence summary on dry weight assessment and management in maintenance hemodialysis patients

Dong Zhijuan; Zhang Hailin; Yin Lixia; Wei Xixi; Zhou Qifan; Chen Fei

doi:10.26939/j.cnki.CN11-9353/R.2024.11.004

Abstract：Objective To integrate the relevant evidence of dry weight assessment and management in maintenance hemodialysis patients and provide reference for clinical decision-making.Methods Clinical guidelines,recommended practices,systematic reviews,evidence summaries,expert consensus and multicenter randomized controlled trials related to dry weight assessment and management were systematically searched from domestic and foreign guideline websites,professional association websites and Chinese and English databases from January 2019 to August 2024.The quality evaluation of the literature was independently completed by two researchers who had received evidence-based training,and the opinions of evidence-based experts were listened to.Evidence was extracted and summarized from the literature that met the quality standards.Results A total of 7 clinical practice guidelines,2 randomized controlled studies,1 expert consensus,1 systematic review,1 recommended practice and 1 evidence summary were included.Finally,8 aspects were summarized,including dry weight assessment methods,dry weight management and optimization,blood pressure control and drug use,dietary assessment and water control,interdialytic weight control,dialysis frequency and dialysis time,use of auxiliary equipment,and biomarker monitoring and adjustment,with a total of 25 recommendations.Conclusion It is recommended that in clinical work in China,a multidisciplinary joint decision-making assessment method be used for the dry weight assessment and management of maintenance hemodialysis patients.In practical applications,medical staff need to select the best evidence based on the specific clinical situation and patient wishes.