Abstract: Objective  To systematically evaluate the factors for gastrointestinal bleeding in maintenance hemodialysis (MHD) patients and provide a reference for early identification and intervention.  Methods A systematic search of databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, VIP and CBM, was carried out to collect the risk factors for gastrointestinal bleeding in MHD patients until October 2022. Meta-analysis was performed by Revman5.3 software.  Results   A total of 16 articles with 154,234 patients were included. Meta-analysis showed that age (HR=1.209, 95% CI: 1.010～1.044, P=0.002), gender (HR=1.210, 95% CI: 1.063～1.377, P=0.004), alcohol consumption (OR=4.272, 95% CI: 1.243～14.679, P=0.020), stimulating diet (OR=4.052, 95% CI: 2.485～6.606, P=0.030), calcium (MD=          -0.241, 95% CI: -0.315～-0.168, P<0.001), platelet count (MD=2.342, 95% CI: 0.140～4.544, P=0.040), prothrombin time (MD=0.704, 95% CI: 0.060～1.348, P=0.030), plasma albumin (MD=-3.842, 95% CI: -6.361～-1.323, P=0.003), hemoglobin (MD=-13.484, 95% CI: -16.496～-10.471, P<0.001), blood creatinine (MD=85.194, 95% CI: 22.716～147.671, P=0.008), blood urea nitrogen (MD=4.540, 95% CI: 0.426～8.653, P=0.030), diabetes mellitus (HR=1.395, 95% CI: 1.257～1.548, P<0.001), liver cirrhosis (HR=1.763, 95% CI: 1.561～1.991, P<0.001), helicobacter pylori infection (OR=4.938, 95% CI: 3.139～7.768, P<0.001), use of non-steroidal anti-inflammatory drugs (HR=1.855, 95% CI: 1.628～2.113, P<0.001), and weekly dialysis time (MD=-1.876, 95% CI: -2.312～-1.440, P<0.001) were the influencing factors for gastrointestinal bleeding in MHD patients.  Conclusion According to the above factors, medical staff can identify the high-risk groups of gastrointestinal bleeding in MHD patients and take intervention measures to reduce the occurrence of gastrointestinal bleeding, improve their medical services, reduce medical costs, and optimize medical resources.

Key words: Maintenance hemodialysis, Gastrointestinal bleeding, Influencing factor