Prevalence of Hypochloremia in Patients With Heart Failure: A Systematic Review and Meta-Analysis.

Aim: The intersection of heart failure (HF) and serum chloride is of increasing interest; however, estimates of the global prevalence of hypochloremia in HF were inconsistent. This paper aimed to quantify the current prevalence of hypochloremia in patients with HF.

Design: Systematic review and meta-analysis.

Methods: PubMed, Cochrane, Embase, Web of Science, and CINAHL databases were systematically searched from inception to May 24, 2022. Observational studies that clearly defined the cutoff for hypochloremia and provided the prevalence of hypochloremia in patients with HF were included. Stata 17.0 was used for data analysis. Heterogeneity was assessed according to Cochran's Q and I² values, and results were pooled using a random-effects model. Sensitivity analysis, subgroup analysis, and meta-regression were used to explore the sources of heterogeneity.

Results: Sixteen papers reporting 18 studies that involved 29,807 patients with HF were included in the meta-analysis. The pooled prevalence of hypochloremia in HF was 14.0% (95% CI: 11.9%-16.2%; I² = 96.6%, I² CI: 95.6%-97.4%, p < 0.001). Study country and study quality were identified in subgroup analysis and meta-regression as possible sources of heterogeneity. Funnel plot and egger's test revealed publication bias (p = 0.02).

Patient or public contribution: No patient or public contribution.