Department of Nephrology, Tianjin First Central Hospital, Tianjin 300192, China.
Comput Math Methods Med. 2022 Jul 18;2022:9469134. doi: 10.1155/2022/9469134. eCollection 2022.
To systematically evaluate the effects of peritoneal dialysis and hemodialysis on renal function and quality of life in patients with end-stage renal disease. An evidence-based medical rationale would be provided for peritoneal dialysis or hemodialysis treatment in patients with end-stage renal disease.
The PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang, and China Biomedical Literature Database (CBM) online databases were searched. Comparisons on the effects of peritoneal dialysis on renal function and quality of life were taken between patients with end-stage renal disease (RD). The data were extracted independently by two researchers. The bias-risk-included literatures were assessed according to the Cochrane manual 5.1.0 standard. RevMan 5.4 statistical software was used to analyze the collected data via meta-analysis.
Seven RCT articles were finally included. A total of 745 samples were analyzed via meta-analysis. The obvious heterogeneities of serum creatinine (Scr) and blood urea nitrogen (BUN) were discovered ( < 0.00001) in the selective investigations. According to the results of this analysis, it was indicated that the renal function of patients with end-stage renal disease treated by peritoneal dialysis was significantly better than that of hemodialysis. According to the meta-analysis, there was obvious heterogeneity of life quality among the included research data. It was indicated that the score of quality of life of patients with end-stage renal disease treated by peritoneal dialysis was significantly better than that of hemodialysis.
Compared with hemodialysis in the treatment of end-stage renal disease, the renal function and quality of life of patients with peritoneal dialysis are better than those of hemodialysis. More further studies and follow-up with higher methodological quality and longer intervention time are still needed for further verification.
系统评价腹膜透析和血液透析对终末期肾病患者肾功能和生活质量的影响,为终末期肾病患者选择腹膜透析或血液透析治疗提供循证医学依据。
计算机检索 PubMed、EMBASE、ScienceDirect、Cochrane Library、中国知网(CNKI)、维普数据库(VIP)、万方数据库和中国生物医学文献数据库(CBM),收集关于腹膜透析与血液透析治疗终末期肾病患者肾功能和生活质量比较的随机对照试验,检索时限均为建库至 2022 年 9 月。由 2 位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 RevMan 5.4 软件进行 Meta 分析。
最终纳入 7 篇 RCT 文献,共 745 例患者。Meta 分析结果显示,血清肌酐(Scr)和血尿素氮(BUN)水平比较的亚组分析结果差异均有统计学意义[Scr:标准化均数差(SMD)=-1.27,95%CI(-1.79,-0.75),P < 0.00001;BUN:SMD=-1.12,95%CI(-1.54,-0.69),P < 0.00001],表明腹膜透析治疗的患者肾功能明显优于血液透析。纳入研究的生活质量评分数据存在异质性,Meta 分析结果显示腹膜透析治疗的患者生活质量评分明显优于血液透析[SMD=-0.44,95%CI(-0.74,-0.14),P=0.003]。
与血液透析相比,腹膜透析治疗终末期肾病患者的肾功能和生活质量更好,但仍需要更多高质量、大样本、长时间的随机对照试验进一步验证。