Peritoneal dialysis access outcomes reported in randomized controlled trials: A systematic review

Area of Science:

• Nephrology
• Surgical Outcomes
• Medical Device Trials

Background:

• Functional peritoneal dialysis (PD) access is essential for successful PD therapy.
• Previous research indicates variability in reporting PD access outcomes.
• This review focuses on PD access flow restriction and operative-related outcomes.

Purpose of the Study:

• To review definitions and measurement methods for PD access outcomes in randomized controlled trials (RCTs).
• To analyze the reporting of PD access flow restriction and operative-related outcomes.
• To identify inconsistencies in outcome reporting across PD access trials.

Main Methods:

• Systematic search of Cochrane CENTRAL, MEDLINE, and EMBASE for RCTs on PD access interventions.
• Data abstraction by two independent reviewers focusing on definitions, outcome measures, and time points.
• Categorization of 817 PD access outcomes from 47 included RCTs.

Main Results:

• PD access flow restriction (91%) and operative-related outcomes (58%) were frequently reported.
• Tip migration (59%) and catheter dysfunction (23%) were common flow restriction outcomes.
• Inconsistent reporting of flow restriction components: description (37%), need for intervention (42%), and etiology (60%).

Conclusions:

• Significant variability exists in the definitions, reporting, and analysis of PD access outcomes across RCTs.
• Operative-related outcomes are underreported.
• Standardized definitions for PD access flow restriction, including description, need for intervention, and etiology, are needed for better evaluation of interventions.