Role of acupressure in symptom management in patients with end-stage renal disease: a systematic review.

Abstract Background: Acupressure is a widely used adjunct for various symptoms in patients with nonchronic kidney disease. However, its role for symptom management in end-stage renal disease (ESRD) populations is not clear. Objective: To summarize and critically evaluate the evidence available from randomized clinical trials (RCTs) of acupressure for patients with ESRD. Design: Systematic review of RCTs. Methods: Thirteen databases were searched from their inceptions through December 2009, irrespective of publication status or language. Results: In total, 7 RCTs out of 86 screened studies were included and analyzed. Most studies lacked sufficient description to gauge the quality of the RCT. Acupressure was not superior to sham acupressure (n = 2) or to transcutaneous electrical stimulation (n = 1), while studies suggested benefits of acupressure compared to usual care (n = 3), sleep medication (n = 1), and undefined control intervention (n = 1). None of these studies reported any adverse events. Conclusion: No definitive conclusion is available. Future trials should adhere to standards of trial methodology and explicitly report relevant information for evaluation of efficacy and safety of acupressure in patients with ESRD.