Internal Medicine Residency Program, University of Miami at Holy Cross Hospital, Ft Lauderdale, FL, USA
Internal Medicine Residency Program, University of Miami at Holy Cross Hospital, Ft Lauderdale, FL, USA.
Perit Dial Int. 2019 Jul-Aug;39(4):306-314. doi: 10.3747/pdi.2018.00227.
Debates exist regarding the merit of starting one dialysis modality over the other for improved cardiovascular outcomes. Five previously published prospective and retrospective cohort studies have reported inconsistent conclusions on this topic. The aim of this systematic review and meta-analysis is to evaluate the influence initiation of hemodialysis (HD) vs peritoneal dialysis (PD) may have on the relative risk (RR) of subsequent development of adverse cardiovascular events (ACVE) in patients with end-stage renal disease (ESRD). Of the 518 records identified, 5 cohort studies, assessing a total of 47,062 patients were included in the meta-analysis. With regard to the subsequent development of ACVE following initiation on the different dialysis modalities, the pooled RR was found to be non-significant. Peritoneal dialysis is a suitable and cost-effective alternative to HD for ESRD patients at risk of cardiovascular disease.
关于起始透析模式对改善心血管结局的优势，目前存在争议。五项已发表的前瞻性和回顾性队列研究就该主题得出了不一致的结论。本系统评价和荟萃分析的目的是评估起始血液透析 (HD) 与腹膜透析 (PD) 对终末期肾病 (ESRD) 患者随后发生不良心血管事件 (ACVE) 的相对风险 (RR) 的影响。在确定的 518 份记录中，纳入了 5 项队列研究，共评估了 47062 名患者。关于不同透析模式起始后 ACVE 的发生，合并 RR 无显著性差异。对于有心血管疾病风险的 ESRD 患者，腹膜透析是 HD 的一种合适且具有成本效益的替代方法。
