Table_2_Chinese experience on comparison of clinical efficacy and safety of hemodialysis and peritoneal dialysis in the treatment of diabetic kidney failure: a systematic review and meta-analysis.DOC

ObjectiveThis meta-analysis aims to compare the efficacy and safety of peritoneal dialysis (PD) and hemodialysis (HD) in the treatment of diabetic kidney failure.
MethodsFive databases were selected to retrieve research on PD and HD for diabetic kidney failure until 6 August 2022. A fixed-effects or random-effects model was utilized to calculate the standardized mean difference (SMD) or odds ratio (OR) based on the heterogeneity among studies.
ResultsSixteen studies were included. The results showed that patients with diabetic kidney failure treated with PD had lower levels of albumin, total protein, and systolic blood pressure (SBP) and higher levels of urine volume, creatinine, and blood urea nitrogen (BUN) and lower risk of cardiovascular and bleeding events, with significant statistical difference when compared with patients treated with HD (albumin: SMD = −1.22, 95%CI: −1.53, −0.91; total protein: SMD = −0.96, 95%CI: −1.16, −0.77; SBP: SMD = −0.35, 95%CI: −0.64, −0.06; urine volume: SMD = 0.68, 95%CI: 0.40, 0.96; creatinine: SMD = 0.49, 95%CI: 0.27, 0.72; BUN: SMD = 0.55, 95%CI: 0.25, 0.85; cardiovascular events: OR = 0.42, 95%CI: 0.28, 0.62; bleeding: OR = 0.41, 95%CI 0.27, 0.62).
ConclusionThis meta-analysis summarized the advantages and disadvantages of PD and HD for treating diabetic kidney failure patients. Compared with HD, PD is more effective in preserving residual kidney function, reducing hemodynamic effect, and lowering the risk of bleeding and cardiovascular events in diabetic kidney failure patients, but it also predisposes to protein-energy malnutrition and increases the risk of infection.

研究目的 本项元分析旨在比较腹膜透析（peritoneal dialysis，PD）与血液透析（hemodialysis，HD）治疗糖尿病性肾衰竭的疗效与安全性。
研究方法 本研究检索了截至2022年8月6日的5个数据库，以获取关于PD与HD治疗糖尿病性肾衰竭的相关研究。根据各纳入研究间的异质性，采用固定效应模型或随机效应模型计算标准化均数差（standardized mean difference，SMD）或比值比（odds ratio，OR）。
研究结果 本研究共纳入16项研究。结果显示，与接受HD治疗的糖尿病性肾衰竭患者相比，接受PD治疗的患者血清白蛋白、总蛋白及收缩压（systolic blood pressure，SBP）水平更低，而尿量、肌酐及血尿素氮（blood urea nitrogen，BUN）水平更高，心血管事件与出血事件风险更低，且差异均具有统计学意义（白蛋白：SMD = −1.22，95%CI：−1.53~−0.91；总蛋白：SMD = −0.96，95%CI：−1.16~−0.77；收缩压：SMD = −0.35，95%CI：−0.64~−0.06；尿量：SMD = 0.68，95%CI：0.40~0.96；肌酐：SMD = 0.49，95%CI：0.27~0.72；血尿素氮：SMD = 0.55，95%CI：0.25~0.85；心血管事件：OR = 0.42，95%CI：0.28~0.62；出血事件：OR = 0.41，95%CI：0.27~0.62）。
研究结论 本项元分析总结了PD与HD治疗糖尿病性肾衰竭患者的临床优劣。与HD相比，PD可更有效地保护糖尿病性肾衰竭患者的残余肾功能，减轻血流动力学影响，降低出血及心血管事件风险，但同时更易引发蛋白质-能量营养不良，且会增加感染风险。