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.

本综述旨在对比腹膜透析（PD）与血液透析（HD）在治疗糖尿病肾衰竭方面的疗效与安全性。研究方法：选取了五个数据库，检索截至2022年8月6日有关PD和HD治疗糖尿病肾衰竭的研究。采用固定效应模型或随机效应模型，基于研究间的异质性，计算标准化均数差（SMD）或比值比（OR）。研究结果：共纳入16项研究。结果显示，接受PD治疗的糖尿病肾衰竭患者，其白蛋白、总蛋白和收缩压（SBP）水平降低，尿量、肌酐和血尿素氮（BUN）水平升高，且心血管和出血事件的风险降低，与接受HD治疗的患者相比，差异具有统计学意义（白蛋白：SMD = −1.22，95%CI: −1.53, −1.91；总蛋白：SMD = −0.96，95%CI: −1.16, −0.77；SBP：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；BUN：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：OR = 0.41，95%CI 0.27, 0.62）。结论：本综述总结了PD和HD在治疗糖尿病肾衰竭患者中的优劣。与HD相比，PD在维持残余肾功能、降低血流动力学影响、减少出血和心血管事件风险方面更为有效，但同时也易导致蛋白质-能量营养不良，并增加感染风险。