Abstract
OBJECTIVE: We aim to analyze the effects of different nonpharmacological interventions on the nutritional status of patients on maintenance hemodialysis (MHD). METHODS: Randomized controlled trials (RCTs) conducted up to October 12, 2023 were searched in the Cochrane Library, Chinese National Knowledge Infrastructure, Wan Fang Database, VIP databases, and China Biomedical Literature Database. R and Review Manager software were used for data analysis, the quality of the literature was assessed using the Cochrane Risk Bias Tool RoB2.0, the reliability of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation guidelines, and sources of heterogeneity were explored through sensitivity analyses. This study was registered in PROSPERO with registration number CRD42023458187. RESULTS: A total of 54 studies met the criteria, 3,861 patients were enrolled in this study, and 11 interventions were explored. The results of the network meta-analysis (NMA) showed that dietary intervention is the best intervention in terms of improving patients' body mass index and serum albumin levels and health education is the best intervention in terms of improving patients' hemoglobin levels. CONCLUSION: This NMA confirmed that different nonpharmacological interventions benefit the nutritional status of patients on MHD, providing novel insights for healthcare practitioners. However, high-quality RCTs should be designed to validate the stability of the level of evidence for different nonpharmacological interventions.