Abstract: Objective To update the systematic review of the influencing factors of frailty in maintenance hemodialysis patients，and to provide references for early identification and intervention of frailty in maintenance hemodialysis patients. Methods Databases were searched incuding CNKI，Wanfang，VIP，SinoMed，PubMed，Cochrane Library，Web of Science，CINAHL，and Embase. The time limit was set from the date of database’s establishment to November 22，2023. All studies and references about the influencing factors of frailty in maintenance hemodialysis patients were searched. After that，two researchers independently screened，extracted and evaluated the literature according to the criteria. Stata 15.0 software was employed for analysis. Results A total of 23 literature were included，with a sample size of 8 644 cases. The results of meta-analysis showed that age，sex，diabetes，peripheral vascular disease，heart disease，cerebrovascular disease，comorbidities，smoking history，diabetic nephropathy，fall history，depression，sleep quality score，nutrition score and hemoglobin are risk factors for frailty；Serum albumin，daily activity score，grip strength and body size were protective factors for frailty（P<0.05）. Meanwhile，underweight，exercise，parathyroid hormone and dialysis adequacy were not associated with frailty（P>0.05）. Conclusion There are many factors influencing frailty in maintenance hemodialysis patients. Future studies can refer to the results of this study，identify the high-risk groups of faltering early，formulate faltering intervention programs，and intervene early to improve the clinical outcomes of patients，so as to improve the quality of life of patients.

Key words: Hemodiafiltration, Frailty, Root cause analysis, Nursing, Meta analysis