腹膜透析与血液透析对于开始透析的人来说
Isabelle Ethier1,2, Ashik Hayat3,4, Juan Pei3,5
1Department of Nephrology, Centre hospitalier de l'Université de Montréal, Montréal, Canada.
The Cochrane database of systematic reviews
|June 20, 2024
概括
腹腔透析 (PD) 和血液透析 (HD) 对功能衰竭患者有不确定的好处和危害. 有限的随机对照试验 (RCT) 和对非随机研究 (NRSI) 的依赖意味着死亡风险和功能保护等结果仍然不清楚.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 脏替代疗法治疗 脏替代疗法
- 临床有效性研究研究 临床有效性研究
背景情况:
- 腹腔透析 (PD) 和血液透析 (HD) 是衰竭的主要治疗方法.
- 比较PD与HD的益处和危害的证据有限,特别是来自随机对照试验 (RCT) 的证据.
- 本综述结合了RCT和干预的非随机研究 (NRSIs),以提供全面的比较.
研究的目的:
- 评价腹腔透析 (PD) 与血液透析 (HD) 对开始透析的患者的比较益处和危害.
- 评估结果,包括残留功能,死亡率,感染,心血管事件,住院和患者报告的结果.
主要方法:
- 搜索了多个数据库 (科克兰脏和移植登记册,CENTRAL,MEDLINE,EMBASE) 来查找2000年至2024年的研究.
- 包括在开始透析的患者中比较PD与HD的RCT和NRSI.
- 两名调查人员独立评估了研究资格,提取了数据,并评估了偏差风险.
主要成果:
- 包括84项研究 (2项RCT,82项NRSI) 在设计和人群中具有显著的异质性.
- 关于残留功能,全因死亡率,心血管死亡和感染相关死亡的PD与HD的证据在很大程度上是不确定的,确定性低至非常低.
- 患PD可能会降低残留功能丧失和细菌病/血流感染发作的风险,但对心血管事件和住院住院的证据仍然不确定.
结论:
- 关于关键结果的PD和HD的比较有效性,如残留功能保存,死亡率和心血管事件是不确定的.
- 数量有限的高质量的RCT和对NRSI的依赖有助于研究结果的不确定性.
- 需要进一步进行高质量的研究,特别是RCT,以澄清PD与HD相比的好处和危害.
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