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

Int Urol Nephrol. 2022 Nov;54(11):2901-2909. doi: 10.1007/s11255-022-03194-5. Epub 2022 Apr 15.

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.

Keywords: End-stage diabetic nephropathy; Hemodialysis; Peritoneal dialysis; Randomized controlled trials.

Publication types

  • Meta-Analysis

MeSH terms

  • Albumins
  • Diabetes Mellitus*
  • Diabetic Nephropathies* / complications
  • Diabetic Nephropathies* / therapy
  • Hemoglobins
  • Humans
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / therapy
  • Peritoneal Dialysis* / adverse effects
  • Peritoneal Dialysis* / methods
  • Randomized Controlled Trials as Topic
  • Renal Dialysis / adverse effects
  • Renal Dialysis / methods

Substances

  • Albumins
  • Hemoglobins