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- Mark R Marshall, Chun-Yuan Hsiao, Philip K Li, Masaaki Nakayama, S Rabindranath, Rachael C Walker, Xueqing Yu, and Suetonia C Palmer.
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. Mark.Marshall@middlemore.co.nz.
- Syst Rev. 2019 Feb 19; 8 (1): 55.
BackgroundAt least 2.6 million adults and children receive dialysis treatment for end-stage kidney disease (ESKD) worldwide. The large majority of these receive hemodialysis (HD), while the remaining receive peritoneal dialysis (PD). Peritoneal dialysis may be associated with similar mortality outcomes as HD, and patient-reported outcomes are potentially increased with PD. Existing evidence for the mortality associated with PD was summarized over 20 years ago, and there has been greater marginal improvement in survival with PD relative to HD since that time. It is therefore timely to reexamine the question of differential mortality by modality and summarize evidence from more contemporary practice settings.Methods/DesignElectronic databases will be systematically searched for publications that report the association between dialysis modality (HD or PD) with death from any cause and cause-specific death in incident patients with end-stage kidney disease. The database searches will be supplemented by searching through citations and references and consultation with experts. Studies published before 1995 will be excluded. Screening of both titles and abstracts will be done by two independent reviewers. All disagreements will be resolved by an independent third reviewer. A quantitative meta-analysis of effect sizes and standard errors will be applied.DiscussionOur systematic review will update previous evidence summaries and provide a quantitative and standardized assessment of the contemporary literature comparing HD and PD including published and unpublished non-English studies from greater China, Taiwan, and Japan. This review will inform shared decision-making around initial dialysis modality choice and jurisdiction-level considerations of dialysis practice.Systematic Review RegistrationPROSPERO CRD42018111829.
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