Comparative Analysis of Efficacy and Prognosis of Hemodialysis and Peritoneal Dialysis for End-Stage Renal Disease: A Meta-analysis

Abstract

Objective. This meta-analysis is aimed at systematically assessing the efficacy and prognosis of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of end-stage renal disease (ESRD). Methods. China National Knowledge Infrastructure, VIP, SinoMed, Cochrane Library, PubMed, and Embase databases were searched for relevant studies to evaluate the two different dialysis methods for ESRD. The search time was set from 2010 to 2021. Meta-analysis was performed using Stata16.0. The treatment group received PD, while the control group was given HD. Results. Out of 317 articles initially retrieved, 14 studies were finally included in our meta-analysis. The analysis results showed that there was no marked difference in the 1-year survival rate between the two groups ( RR = 1.05 ; 95% CI: 1.00, 1.10; P > 0.05 ), but the incidence rate of adverse reactions in the treatment group was significantly lower than that in the control group ( RR = 0.51 ; 95% CI: 0.37, 0.70; P < 0.05 ). In addition, PD and HD treatments caused significant decreases in serum creatinine levels (PD, SMD = − 2.91 ; 95% CI: -3.79, -2.04; P < 0.05 ; HD, SMD = − 3.09 ; 95% CI: -4.01, -2.16; P < 0.05 ) and blood urea nitrogen levels (PD, SMD = − 2.54 , 95% CI: -3.37, -1.72, P < 0.05 ; HD, SMD = − 2.62 , 95% CI: -3.47, -1.77, P < 0.05 ); however, there was no significant statistical difference in posttreatment levels of serum creatinine and blood urea nitrogen between the two groups. Compared with the control group, the hemoglobin ( SMD = 0.56 , 95% CI: 0.07, 1.06; P < 0.05 ) and serum albumin ( SMD = 1.11 , 95% CI: 0.46, 1.76, P < 0.05 ) levels were significantly increased in the treatment group after treatment. Conclusion. In summary, both PD and HD can improve renal function in uremic patients, but PD is superior to HD in reducing the incidence of adverse reactions, improving the nutritional status, and therefore improving the quality of life of patients.

Effects and Clinical Value of Peritoneal Dialysis on Water and Water Balance, Adverse Reactions, Quality of Life, and Clinical Prognosis in Patients with Decompensated Chronic Nephropathy: A Systematic Review and Meta-Analysis

“…The survival rate of patients with renal function is higher than that of 5 Computational and Mathematical Methods in Medicine patients without renal function, and the quality of life of patients with renal function is better than that of patients without renal function. Because of the different dialysis characteristics of HD and PD, some studies have shown that PD can protect patients' renal function better than HD [52,53]. In PD patients, the loss of renal function can be slowed down by using renin-angiotensin-aldosterone system blockers and diuretics.…”

Does temporary transfer to preoperative hemodialysis influence postoperative outcomes in patients on peritoneal dialysis? A retrospective cohort study

“…Firstly, we observed that patients switching to HD preoperatively had a significantly lower postoperative BUN and SCr levels. This could be explained by a major difference in dialysis principles between PD and HD: HD is more effective in removing small molecules and water while PD is better capable at the removal of middle molecular substances (19). In spite of that, patients in the preoperative HD group seemed to have a higher proportion of postoperative complications than patients in the preoperative PD group, especially a higher incidence of hyperkalemia.…”

Clinical observation and influence on nutritional status of intensive nutritional nursing combined with 3‐day dietary diary intervention in peritoneal dialysis patients

“…[12][13][14] Studies have shown that the incidence of malnutrition in long-term peritoneal dialysis patients is over 70%, and malnutrition directly affects the prognosis and survival of patients on dialysis. 15,16 Because of the high prevalence of coexisting problems in peritoneal dialysis patients, as well as the fact that each patient is unique, individualised nutrition therapy is essential for such patients. However, there is no uniform implementation standard, and the intervention effect and risk factors remain to be further explored.…”

“…Accordingly, patients will inevitably lose some nutrients during the process of peritoneal dialysis, resulting in a nutritional imbalance and the subsequent appearance of some symptoms such as malnutrition and abnormal calcium and phosphorus metabolism 12–14 . Studies have shown that the incidence of malnutrition in long‐term peritoneal dialysis patients is over 70%, and malnutrition directly affects the prognosis and survival of patients on dialysis 15,16 . Because of the high prevalence of coexisting problems in peritoneal dialysis patients, as well as the fact that each patient is unique, individualised nutrition therapy is essential for such patients.…”