Table_1_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.DOCX

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.

本研究旨在通过荟萃分析，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：选取五个数据库，检索至2022年8月6日为止关于PD和HD治疗糖尿病肾衰竭的相关研究。采用固定效应模型或随机效应模型，根据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，与接受HD治疗的患者相比，接受PD治疗的患者具有较低的血清白蛋白、总蛋白和收缩压（SBP）水平，以及较高的尿量、肌酐和血尿素氮（BUN）水平，且心血管和出血事件的风险更低，差异具有统计学意义（白蛋白：SMD=−1.22，95%CI：−1.53，−0.91；总蛋白：SMD=−0.96，95%CI：−1.16，−0.77；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：本研究总结了PD和HD治疗糖尿病肾衰竭患者的利弊。与HD相比，PD在保留残余肾功能、减轻血流动力学影响、降低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。