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Background: Anemia is extremely common among dialysis patients and underlies some of the symptoms associated with reduced kidney function, including fatigue, depression, reduced exercise tolerance, and dyspnea. Objectives: A clearer cognition of the prognosistic impact of hemoglobin (Hb) or hematocrit (Hct) target for the outcomes of dialysis patients is urgent. This article aims to establish the suitable hemoglobin in order to provide clinical guidance. Methods: MEDLINE, EmBase, the Cochrane Library and other databases were searched with both MeSH terms and keywords to gather randomized controlled trials that assessed all-cause mortality, cardiovascular events, fistula thrombosis, infectious diseases and transfusion among dialysis-dependent patients using erythropoiesis-stimulating agents. The meta-analysis was accomplished via Revman 5.3 version. Findings: Totally, nine eligible studies were included, with study subjects involving 3228 patients. There was a significantly higher risk of fistula thrombosis without heterogeneity (RR 1.34, 95% CI 1.15–1.55; p

// Xilian Qiu 1, * , Chunyong Liu 2, * , Yuqiu Ye 3, * , Huiqun Li 3 , Yanbing Chen 4 , Yongmei Fu 3 , Zhenjie Liu 2 , Xianzhang Huang 2 , Yunqiang Zhang 5 , Xueyuan Liao 5 , Hongyong Liu 5, * , Wenbo Zhao 3 and Xun Liu 5, 3 1 Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China 2 Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China 3 Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China 4 Medical genetic center, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China 5 Division of Nephrology, The 3rd Affiliated Hospital of Sun Yat-sen University, Yuedong Hospital, Meizhou, China * These authors contributed equally to this work Correspondence to: Xun Liu, email: naturestyle@163.com Wenbo Zhao, email: bobo800101@foxmail.com Hongyong Liu, email: 13823850589@139.com Keywords: creatinine, cystatin C, glomerular filtration rate, meta-analysis Received: June 07, 2017 Accepted: July 30, 2017 Published: August 16, 2017 ABSTRACT Background: Serum biomarkers, such as serum creatinine (SCr) and serum cystatin C (SCysC), have been widely used to evaluate renal function in patients who have chronic kidney disease (CKD). Objective: This article aims to assess the value of determining SCr and SCysC levels in patients that have long-term kidney disease. Approaches: MEDLINE, EmBase, the Cochrane Library and other databases were searched using both MeSH terms and text words to collect research that assessed the diagnostic value of using SCr and SCysC to evaluate Glomerular Filtration Rate (GFR) in patients with CKD. Data were converted into fourfold tables. Summary Receiver Operating Characteristic Curves and meta-analyses were accomplished via Meta-Disc version 1.4. Results: In total, 21 relevant articles involving 3112 study subjects were included in our review. Results showed that the collective sensitivity for SCr and SCysC was 0.77 (95% CI: 0.69–0.84) and 0.87 (95% CI: 0.82–0.91), respectively. The pooled specificity for SCr and SCysC was 0.91 (95% CI: 0.86–0.94) and 0.87 (95% CI: 0.82–0.91), respectively. Subgroup analyses demonstrated that when GFR cut-off values are set to 60 (ml/min/1.73 m 2 ), the pooled sensitivity is 0.94 (95% CI: 0.90–0.96) for SCysC and 0.75 (95% CI: 0.68–0.82) for SCr. Conclusions: The diagnostical accuracy for impaired kidney function favors SCysC. Confidence intervals for the pooled sensitivity and specificity for SCr and SCysC overlap. However, SCysC is more sensitive for estimating GFR than SCr when GFR cut-off values are set to 60 (ml/min/1.73 m 2 ).

Background Evening dosing regimen drug therapy on blood pressure (BP) control is used widely, but its clinical benefits and preservation or re-establishment of normal 24-hour BP dipping pattern in chronic kidney disease (CKD) patients is not known. Aims To investigate the effect of evening dosing regimen of antihypertensive drugs on blood pressure patterns to CKD patients with hypertension. Methods We did a systematic review by searching PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference lists of relevant articles of published papers. All trials designed to evaluate the effects of evening versus morning dosing regimen drug therapy for CKD patients with hypertension were included. Meta-analysis was performed using random or fixed effects models. Results Five randomized controlled trials (RCTs) and one comparative study, including 3732 patients met the inclusion criteria. Compared with morning dosing regimen drug therapy, evening administration of antihypertensive medication was associated with a significant reduction of 40% in non-dipper BP patterns (risk ratio [RR], 95% CI, [0.43, 0.84]). We noted a significant decrease in nocturnal systolic blood pressure (SBP) (MD −3.17 mmHg, 95% CI, [−5.41, −0.94]), a significant reduction in nocturnal diastolic blood pressure (DBP) (MD −1.37 mmHg. 95% CI. [−2.05, −0.69]) and a significant increase in awake SBP (MD 1.15 mmHg, 95% CI, [0.10, 2.19]) in patients assigned to evening dosing regimen drug therapy group. Patients showed no significant differences for all-cause mortality and cardiovascular mortality. Conclusion This review shows that evening dosing regimen drug therapy could reverse non-dipper BP patterns in hypertensive CKD patients.

Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. This article aims to establish the suitable hemoglobin target to provide clinical guidance. MEDLINE, EmBase, the Cochrane Library and other databases were searched with both MeSH terms and keywords to gather researches that assessed all-cause mortality, stroke, treatment of renal replacement, and transfusion. The meta-analysis was accomplished via Revman 5.3 version. Totally, 13 eligible studies involving 7606 patients were included. There was a significantly lower risk of transfusion (risk ratio (RR) 0.59, 95% CI 0.52 to 0.67; p