Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation
Abstract Background Regarding lupus disease activity, morbidity and survival, limited literature concluded conflicting results when comparing hemodialysis versus peritoneal dialysis as initial renal replacement therapies (RRT) prior to transplantation, in lupus nephritis end-stage renal disease (LN-...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-020-01811-y |
| _version_ | 1818578270443012096 |
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| author | Joel Swai Xiexiong Zhao Julie-Raisa Noube Gui Ming |
| author_facet | Joel Swai Xiexiong Zhao Julie-Raisa Noube Gui Ming |
| author_sort | Joel Swai |
| collection | DOAJ |
| description | Abstract Background Regarding lupus disease activity, morbidity and survival, limited literature concluded conflicting results when comparing hemodialysis versus peritoneal dialysis as initial renal replacement therapies (RRT) prior to transplantation, in lupus nephritis end-stage renal disease (LN-ESRD) patients. This study was aimed to compare the risks of lupus flares, all-cause infections, all-cause cardiovascular events, and mortality, between hemodialysis versus peritoneal dialysis as initial RRT - modality before renal-transplant in LN-ESRD patients, by systematic review and meta-analysis. Methods PubMed, EMBASE, and SCOPUS were searched for observational-studies comparing LN-ESRD -patients undergoing hemodialysis (Group1) versus peritoneal-dialysis (Group 2) prior to renal-transplantation, by their risks of lupus flare, all-cause infections, all-cause cardiovascular events, and mortality as outcome measures. Relative-Risks of outcomes between the groups measured overall effects at a 95% significance level. RevMan 5.3 computer software was used for analysis. Results From search, 16 eligible studies reported 15,636 LN-ESRD -patients prior to renal transplantation with 4616 patients on hemodialysis, 2089 on peritoneal dialysis, 280 directly underwent kidney transplantation, 8319 were eliminated with reasons and 332 participants’ details were not reported. Hemodialysis group had higher risk of all-cause cardiovascular events, Relative-Risk = 1.44 (Confidence Interval:1.02, 2.04), p-Value< 0.05. With regards to risks for mortality, flare and all-cause infections, there were trends that were not statistically significant (p-Value> 0.05). Conclusion Except for all-cause cardiovascular events in which peritoneal dialysis is superior to hemodialysis offering better outcomes, both treatment modalities offer more or less similar clinical outcomes as effective initial choices of RRT in LN-ESRD patients prior to renal transplant. The protocol registration PROSPERO 2019 CRD42019131600 . |
| first_indexed | 2024-12-16T06:43:08Z |
| format | Article |
| id | doaj.art-050e2dedcef24598b22a18b34f989c1d |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-16T06:43:08Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-050e2dedcef24598b22a18b34f989c1d2022-12-21T22:40:37ZengBMCBMC Nephrology1471-23692020-05-0121111010.1186/s12882-020-01811-ySystematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantationJoel Swai0Xiexiong Zhao1Julie-Raisa Noube2Gui Ming3Department of Nephrology and Rheumatology, Xiangya Third Hospital, Central South UniversityDepartment of Cardiology, Xiangya Third Hospital, Central South UniversityDepartment of Gastroenterology, Xiangya Third Hospital, Central South UniversityDepartment of Nephrology and Rheumatology, Xiangya Third Hospital, Central South UniversityAbstract Background Regarding lupus disease activity, morbidity and survival, limited literature concluded conflicting results when comparing hemodialysis versus peritoneal dialysis as initial renal replacement therapies (RRT) prior to transplantation, in lupus nephritis end-stage renal disease (LN-ESRD) patients. This study was aimed to compare the risks of lupus flares, all-cause infections, all-cause cardiovascular events, and mortality, between hemodialysis versus peritoneal dialysis as initial RRT - modality before renal-transplant in LN-ESRD patients, by systematic review and meta-analysis. Methods PubMed, EMBASE, and SCOPUS were searched for observational-studies comparing LN-ESRD -patients undergoing hemodialysis (Group1) versus peritoneal-dialysis (Group 2) prior to renal-transplantation, by their risks of lupus flare, all-cause infections, all-cause cardiovascular events, and mortality as outcome measures. Relative-Risks of outcomes between the groups measured overall effects at a 95% significance level. RevMan 5.3 computer software was used for analysis. Results From search, 16 eligible studies reported 15,636 LN-ESRD -patients prior to renal transplantation with 4616 patients on hemodialysis, 2089 on peritoneal dialysis, 280 directly underwent kidney transplantation, 8319 were eliminated with reasons and 332 participants’ details were not reported. Hemodialysis group had higher risk of all-cause cardiovascular events, Relative-Risk = 1.44 (Confidence Interval:1.02, 2.04), p-Value< 0.05. With regards to risks for mortality, flare and all-cause infections, there were trends that were not statistically significant (p-Value> 0.05). Conclusion Except for all-cause cardiovascular events in which peritoneal dialysis is superior to hemodialysis offering better outcomes, both treatment modalities offer more or less similar clinical outcomes as effective initial choices of RRT in LN-ESRD patients prior to renal transplant. The protocol registration PROSPERO 2019 CRD42019131600 .http://link.springer.com/article/10.1186/s12882-020-01811-yRenal DialysisLupus nephritisKidney failure, chronicMeta-analysis |
| spellingShingle | Joel Swai Xiexiong Zhao Julie-Raisa Noube Gui Ming Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation BMC Nephrology Renal Dialysis Lupus nephritis Kidney failure, chronic Meta-analysis |
| title | Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation |
| title_full | Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation |
| title_fullStr | Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation |
| title_full_unstemmed | Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation |
| title_short | Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation |
| title_sort | systematic review and meta analysis of clinical outcomes comparison between different initial dialysis modalities in end stage renal disease patients due to lupus nephritis prior to renal transplantation |
| topic | Renal Dialysis Lupus nephritis Kidney failure, chronic Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12882-020-01811-y |
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