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Safety and efficacy of hemodialysis and peritoneal dialysis in treating end-stage diabetic nephropathy: a meta-analysis of randomized controlled trials

  • Nephrology - Original Paper
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Abstract

Background

Present investigation aims to elucidate safety and efficacy of hemodialysis as well as peritoneal dialysis in treating end-stage diabetic nephropathy.

Methods

We searched various databases for articles from the database starting date to October 2019. The analysis involved studies that contained outcomes of hemodialysis and peritoneal dialysis in the treatment of end-stage diabetic nephropathy. A total of 12 randomized controlled trials (RCTs) with 932 participants were collected.

Results

Meta-analysis results suggested that comparing with peritoneal dialysis group, hemodialysis group had a higher incidence of cardiovascular and cerebrovascular events and bleeding complications. There was no statistically significant difference regarding the infection (P = 0.71) or malnutrition (P = 0.53) incidence between the two forms of dialysis. Hemodialysis could better improve the levels of albumin [mean difference (MD) = 6.80, 95% CI = (4.17–9.44)] and hemoglobin [MD = 3.40, 95% CI = (0.94–5.86)] than peritoneal dialysis after 3 months or more.

Conclusions

In treating end-stage diabetic nephropathy patients, peritoneal dialysis had a lower incidence of cardiovascular and cerebrovascular events, as well as bleeding complication than hemodialysis. However, hemodialysis could better improve albumin and hemoglobin levels than peritoneal dialysis after 3 months.

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Author information

Authors and Affiliations

  1. Department of Nephrology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, China

    Menglin Zou

  2. Hospital of Jiangxi Provincial Armed Police Corps, Nanchang, People’s Republic of China

    Jianjun Xie

  3. Department of Nephrology, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Avenue, Nanchang City, Jiangxi Province, China

    Lili Lan, Yiye Zhang, Liqing Tian, Man Chen & Yan Yan

Authors
  1. Menglin Zou
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  2. Jianjun Xie
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  3. Lili Lan
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  4. Yiye Zhang
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  5. Liqing Tian
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  6. Man Chen
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  7. Yan Yan
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Corresponding author

Correspondence to Yan Yan.

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Supplementary Information

Below is the link to the electronic supplementary material.

11255_2022_3194_MOESM1_ESM.png

Supplementary file1 Supplementary Figure1. Study selection flow diagram. DKD, diabetic kidney disease; HD, hemodialysis; PD, peritoneal dialysis; RCTs, randomized controlled trials. (PNG 317 KB)

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Supplementary file2 Supplementary Figure 2. Risk of bias summary review authors’ judgments about each risk of bias item for each included study. (PNG 211 KB)

Supplementary file3 Supplementary Figure 3. Sensitivity analysis on plasma albumin levels in both groups. (PNG 85 KB)

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Supplementary file4 Supplementary Figure 4. Forest plot based on comparison of albumin between hemodialysis and peritoneal dialysis after excluding the one articles. (PNG 176 KB)

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Supplementary file5 Supplementary Figure 5. Publication bias according to Begg’s test funnel plots with plasma albumin. (PNG 38 KB)

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Supplementary file6 Supplementary Figure 6. Publication bias according to Egger’s test funnel plots with plasma albumin. (PNG 35 KB)

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Supplementary file7 Supplementary Figure 7. Publication bias according to Begg’s test funnel plots with hemoglobin. (PNG 36 KB)

11255_2022_3194_MOESM8_ESM.png

Supplementary file8 Supplementary Figure 8. Publication bias according to Egger’s test funnel plots with hemoglobin. (PNG 38 KB)

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Zou, M., Xie, J., Lan, L. et al. Safety and efficacy of hemodialysis and peritoneal dialysis in treating end-stage diabetic nephropathy: a meta-analysis of randomized controlled trials. Int Urol Nephrol 54, 2901–2909 (2022). https://doi.org/10.1007/s11255-022-03194-5

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  • DOI: https://doi.org/10.1007/s11255-022-03194-5

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