Meta-analysis Of Factors Influencing Diuretic Resistance In Heart Failure Combined With Diuretic Resistanc

Objective: To systematically evaluate the influencing factors of heart failure combined with diuretic resistance so as to provide evidence-based evidence for prevention,diagnosis,and treatment of heart failure patients in clinical work.Methods: The literature on factors affecting heart failure combined with diuretic resistance from January 2000 to January 2022 in each database was searched.The retrieved literature was screened using inclusion and exclusion criteria,and the quality of the included literature was assessed using the NOS scale.Excel was used to extract and collate relevant information,and meta-analysis of the extracted and collated data was performed using Rev Man 5.4 and Stata 14.0 software.Results:1.A total of 12 literatures on influencing factors of heart failure combined with diuretic resistance were included,and one of them studied two cohort studies at the same time,so two sets of data could be extracted.There were a total of 5365 patients,including 3142 males(58.56%)and2223 females(41.44%).Experimental group: 2301 people;control group:3064 people;the patients included 3851 with acute heart failure and 1514 with chronic heart failure;10 related factors were involved.2.Meta-analysis showed that influencing factors such as glomerular filtration rate,blood urea nitrogen,uric acid,blood creatinine,systolic blood pressure,diastolic blood pressure,blood sodium,hemoglobin,diabetes mellitus,and renal disease were correlated with heart failure combined with diuretic resistance(P<0.05).Compared with patients with heart failure without combined diuretic resistance,patients with heart failure with combined diuretic resistance had higher glomerular filtration rate [WMD=-7.20,95% CI(-8.80 to-5.61)],systolic blood pressure[WMD=-5.62,95% CI(-6.84 to-4.39)],diastolic blood pressure [WMD=-5.03,95% CI(-6.04 to-4.02)],blood sodium [WMD=-0.88,95% CI(-1.18to-0.59)] and hemoglobin [WMD=-5.33,95% CI(-6.56 to-4.09)] levels were lower;compared with patients with heart failure without diuretic resistance,patients with heart failure with diuretic resistance had lower blood creatinine [WMD=20.31,95% CI(16.22 to 24.40)],blood urea nitrogen [WMD=2.28,95% CI(1.95 to 2.60)] and uric acid [WMD=37.06,95% CI(24.78 to 49.35)] levels were higher in patients with heart failure combined with diuretic resistance compared with patients without heart failure combined with diuretic resistance;patients with heart failure combined with diuretic resistance had higher levels of diabetes [OR=2.20,95% CI(1.69 to 2.41)],kidney disease [OR=1.98,95% CI(1.65 to 2.39)],and a higher proportion of patients with heart failure combined with diuretic resistance.3.The Egger’s and Begg’s tests showed that there was no significant publication bias in other factors except diabetes mellitus(P=0.042)and UA(P=0.007)and Egger’s test(P<0.05).Conclusion:1.Glomerular filtration rate,systolic blood pressure,diastolic blood pressure,blood sodium,and hemoglobin were factors affecting diuretic resistance in heart failure combined with diuretic resistance,and glomerular filtration rate,systolic blood pressure,diastolic blood pressure,blood sodium,and hemoglobin levels were lower in heart failure combined with diuretic resistance patients.2.Blood urea nitrogen,blood creatinine,and uric acid were factors influencing diuretic resistance in heart failure combined with diuretic resistance,and the levels of blood creatinine,blood urea nitrogen,and uric acid were higher in heart failure combined with diuretic resistance patients.3.Renal disease and diabetes mellitus were factors affecting heart failure combined with diuretic resistance,and a higher percentage of patients with heart failure combined with diuretic resistance had diabetes mellitus and renal disease.