{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T05:54:03Z","timestamp":1793944443269,"version":"4.8.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"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. Public Health"],"abstract":"\n Background<\/jats:title>\n The number of patients with chronic kidney disease (CKD) continues to rise in China, where maintenance hemodialysis (MHD) is a primary treatment. However, long-term hemodialysis is frequently associated with malnutrition, which severely compromises patients\u2019 quality of life and prognosis.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To systematically evaluate the incidence and influencing factors of malnutrition in MHD patients by using Meta-analysis methods, thereby providing a basis for early clinical identification and intervention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We systematically searched PubMed, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), VIP, Wan Fang Data and SinoMed. The search covered the period from database inception to October 10, 2025, for studies investigating factors influencing malnutrition in MHD patients. Data were analyzed using Stata 15.0. A random-effects model was applied in cases of substantial heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f\u2265\u202f50%), otherwise a fixed-effects model was used. Publication bias was assessed using Egger\u2019s test, and the trim-and-fill method was employed if necessary.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 26 studies involving 5,055 patients were included, and the overall incidence of malnutrition in MHD patients was 46.9% (95% CI: 41.8\u201352%). Meta-analysis showed that age (OR\u202f=\u202f1.509), body mass index (BMI) (OR\u202f=\u202f1.544), dialysis vintage (OR\u202f=\u202f2.265), urea clearance index (Kt\/V) (OR\u202f=\u202f2.019), serum C-reactive protein (CRP) (OR\u202f=\u202f3.013), high-sensitivity C-reactive protein (hs-CRP) (OR\u202f=\u202f2.104), protein intake (OR\u202f=\u202f3.018), frequency of dialysis (OR\u202f=\u202f2.100), depression (OR\u202f=\u202f2.671), anxiety (OR\u202f=\u202f2.531), monthly household income (OR\u202f=\u202f1.563), serum albumin (ALB) (OR\u202f=\u202f1.115), frequency of erythropoietin (EPO) use (OR\u202f=\u202f1.506) and duration of dialysis per session (OR\u202f=\u202f1.879) were the main influencing factors (\n p<\/jats:italic>\n \u202f&lt;\u202f0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Malnutrition is present in 46.9% of maintenance hemodialysis patients. Individualized assessment and intervention targeting these key factors are essential to improve nutritional status and patient prognosis.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n , registration no. CRD42024596946.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1771997","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T16:02:35Z","timestamp":1772812955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and influencing factors of malnutrition in maintenance hemodialysis patients in China: a systematic review"],"prefix":"10.3389","volume":"14","author":[{"given":"Yanan","family":"Ban","sequence":"first","affiliation":[{"name":"Blood Purification Centre, Lianyungang Clinical College of Nanjing Medical University","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Blood Purification Centre, Lianyungang Clinical College of Nanjing Medical University","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Nursing, Lianyungang Clinical College of Nanjing Medical University","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Fourth People\u2019s Hospital of Lianyungang","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Wen","sequence":"additional","affiliation":[{"name":"Blood Purification Centre, The Affiliated Lianyungang Hospital of Xuzhou Medical University","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixia","family":"Yin","sequence":"additional","affiliation":[{"name":"Blood Purification Centre, Lianyungang Clinical College of Nanjing Medical University","place":["Lianyungang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1016\/j.kint.2020.09.003","article-title":"Executive summary for China kidney disease network (CK-NET) 2016 annual data report","volume":"98","author":"Yang","year":"2020","journal-title":"Kidney Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.3390\/jcm12062113","article-title":"Recent advances in the nutritional screening, assessment, and treatment of japanese patients on hemodialysis","volume":"12","author":"Ishida","year":"2023","journal-title":"J Clin Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.3390\/nu13041371","article-title":"Assessment of factors related to diminished appetite in hemodialysis patients with a new adapted and validated 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renal failure","volume":"47","author":"Guo","year":"2025","journal-title":"J Shandong Med Coll"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3969\/j.issn.1008-0104.2025.06.019","article-title":"Analysis of high-risk factors for malnutrition in elderly chronic kidney disease patients undergoing maintenance hemodialysis","volume":"48","author":"Yan","year":"2025","journal-title":"Heilongjiang Med Pharm"},{"key":"ref37","first-page":"60","article-title":"Risk factors of malnutrition in maintenance hemodialysis patients with end-stage renal disease","volume":"29","author":"Li","year":"2023","journal-title":"Contemp Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3969\/j.issn.2095-7165.2023.04.008","article-title":"Analysis of influencing factors for malnutrition in maintenance hemodialysis patients","volume":"13","author":"Song","year":"2023","journal-title":"Physician 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