Effectiveness of Nursing and Non-Pharmacological Interventions in Reducing Intradialytic Hypotension Among Haemodialysis Patients: A Systematic Review and Meta-Analysis.

GRADE rated all outcomes as very low certainty because of risk of bias, inconsistency, indirectness and imprecision. The pooled systolic blood pressure effect had very high heterogeneity, so the average result may not apply to any one intervention or patient group. Systolic blood pressure was a surrogate outcome, and the review did not show that interventions reduced intradialytic hypotension episodes or improved patient-centred outcomes. Many studies were single-centre, small, quasi-experimental or had unclear blinding and allocation concealment. The nurse-led subgroup included only 4 studies and 110 participants, so its result was imprecise. No uniform operational definition of intradialytic hypotension was applied across studies.

The work was supported by Chungbuk National University NUDP program 2025. The authors declared no conflicts of interest.

Do not read the systolic blood pressure result as proof that nurse-led bedside interventions reduce intradialytic hypotension episodes. The nurse-led subgroup was not statistically significant, and systolic blood pressure is a surrogate outcome.