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 ( $\text{RR}=1.05$ ; 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 ( $\text{RR}=0.51$ ; 95% CI: 0.37, 0.70; $P<0.05$ ). In addition, PD and HD treatments caused significant decreases in serum creatinine levels (PD, $\text{SMD}=-2.91$ ; 95% CI: -3.79, -2.04; $P<0.05$ ; HD, $\text{SMD}=-3.09$ ; 95% CI: -4.01, -2.16; $P<0.05$ ) and blood urea nitrogen levels (PD, $\text{SMD}=-2.54$ , 95% CI: -3.37, -1.72, $P<0.05$ ; HD, $\text{SMD}=-2.62$ , 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 ( $\text{SMD}=0.56$ , 95% CI: 0.07, 1.06; $P<0.05$ ) and serum albumin ( $\text{SMD}=1.11$ , 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.