{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:00:16Z","timestamp":1786636816346,"version":"build-2736575974"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n Malnutrition is a common and severe complication in maintenance hemodialysis patients, which significantly increases the risk of adverse clinical outcomes. Traditional Chinese medicine (TCM) has emerged as a promising adjunctive therapy for nutritional improvement, yet its efficacy and underlying mechanisms require systematic clarification. This study synthesized the evidence to explore the role of TCM in managing malnutrition in hemodialysis populations. These findings aim to inform evidence-based decisions regarding its clinical applicability.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n A systematic literature search was conducted across four international biomedical databases (e.g., PubMed, Embase, Web of Science, ClinicalTrials.gov) and three Chinese scholarly platforms (CNKI, Wanfang, CQVIP), with the search period spanning from March 2016 to March 2026. We systematically reviewed randomized controlled trials (RCTs) evaluating TCM interventions on nutritional status improvement in patients undergoing maintenance hemodialysis. Stata version 12.0 statistical software (StataCorp LP, College Station, Texas) was adopted as statistical software. When I\n 2<\/jats:sup>\n &lt;\u202f50%, we consider the data has no obvious heterogeneity, and we conduct a meta-analysis using the fixed-effect model. Otherwise, the random-effect model was performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This meta-analysis included 26 randomized controlled trials (RCTs) conducted in China, involving a total of 2,263 patients with uremia. Among them, 1,135 patients received traditional Chinese medicine treatment in addition to maintenance hemodialysis and standard care, while the remaining 1,128 patients did not receive TCM treatment. Our analysis found that traditional Chinese medicine significantly improved overall response rate compared with the control group (RR\u202f=\u202f1.460; 95% CIs: 1.310 to 1.626;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). For nutritional indicators, TCM was associated with significant improvements in serum albumin (WMD\u202f=\u202f3.009; 95% CIs: 2.149 to 3.869;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), hemoglobin (WMD\u202f=\u202f7.975; 95% CIs: 5.901 to 10.048;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), triceps skinfold thickness (WMD\u202f=\u202f1.119; 95% CIs: 0.605 to 1.634;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), residual kidney function (WMD\u202f=\u202f0.991; 95% CIs: 0.685 to 1.297;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), transferrin (WMD\u202f=\u202f0.607; 95% CIs: 0.266 to 0.948,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), total cholesterol (WMD\u202f=\u202f0.467; 95% CIs: 0.175 to 0.759;\n p<\/jats:italic>\n \u202f=\u202f0.002), and modified quantitative subjective global assessment scores (WMD\u202f=\u202f\u22122.613; 95% CIs: \u22123.694 to \u22121.532;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). No significant differences were observed in body mass index, mid-arm circumference, leptin, subjective global assessment, or malnutrition inflammation score. Four studies reported adverse events, with no significant difference between groups (RR\u202f=\u202f1.335; 95% CIs: 0.358 to 4.972;\n p<\/jats:italic>\n \u202f=\u202f0.667).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Among the included patients undergoing maintenance hemodialysis, traditional Chinese medicine demonstrated efficacy in improving nutritional status, with significant improvements observed across multiple nutritional indicators and no increase in the risk of adverse events. Nevertheless, given the inherent heterogeneity among the included studies, further high-quality evidence is warranted to support these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1852062","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:01:16Z","timestamp":1786633276000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of traditional Chinese medicine in improving nutritional status among Chinese maintenance hemodialysis patients: a meta-analysis of the last decade"],"prefix":"10.3389","volume":"13","author":[{"given":"Buqing","family":"Xu","sequence":"first","affiliation":[{"name":"Blood Purification Center, Zhejiang Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Cao","sequence":"additional","affiliation":[{"name":"Blood Purification Center, Zhejiang Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic kidney disease","volume":"389","author":"Webster","year":"2017","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.2215\/CJN.10561015","article-title":"A thematic synthesis of the experiences of adults living with hemodialysis","volume":"11","author":"Reid","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e1378","DOI":"10.1016\/S2214-109X(25)00198-6","article-title":"Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies, 1990\u20132023: a systematic analysis for the global burden of disease study 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Chinese hemodialysis population","volume":"10","author":"Chen","year":"2013","journal-title":"Int J Med Sci"},{"key":"ref38","first-page":"31","article-title":"Nutritional status assessment and clinical significance in non-dialysis chronic kidney disease patients","volume":"15","author":"Ding","year":"2017","journal-title":"Assessment and Analysis of Nutritional Status in non-dialytic Chronic Kidney Disease Patients"},{"key":"ref39","first-page":"3851","article-title":"Study on the characteristics of traditional Chinese medicine syndromes based on statistical analysis methods in hemodialysis patients of end-stage renal disease","volume":"40","author":"Yan","year":"2025","journal-title":"China J Tradit Chin Med Pharm"},{"key":"ref40","first-page":"539","article-title":"Chinese clinical practice guideline for nutritional management of chronic kidney disease (2021)","volume":"101","year":"2021","journal-title":"Natl Med J China"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1852062\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:01:22Z","timestamp":1786633282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1852062\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":40,"alternative-id":["10.3389\/fnut.2026.1852062"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1852062","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1852062"}}