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First page of A Comparison of Clinical Outcomes in Urgent-Start Hemodialysis vs. Urgent-Start Peritoneal Dialysis in ESRD patients: A Systematic Review and Meta-Analysis

Background: USPD is related to fewer complications and lower mortality rates compared to USHD in patients who need renal replacement therapy. However, there is a lack of literature specifically addressing its application and results in individuals with ESRD. Objective: A comprehensive examination and synthesis of existing research were conducted to compare fellow up outcomes of USPD versus USHD in ESRD patients . Methods: A comprehensive search was conducted in PubMed, Web of Science, and the Cochrane Library, and SpringerLink databases for that compare urgent-start PD to urgent-start HD before November 1th, 2024. Mortality, all complications, noninfectious complications, infectious complications, bacteraemia and peritonitis were used as outcomes to compare USPD and USHD. Results: This meta-analysis incorporated seven studies involving a total of 1,338 patients. Our findings showed no notable distinctions in peritonitis between USPD and USHD. urgent-start PD was linked to a reduced mortality rate “(OR: 0.48, 95% CI: 0.24 to 0.95, p < 0.05), lower all complications (OR: 0.27, 95% CI: 0.20 to 0.37, p < 0.05), lower noninfectious complications(OR: 0.32, 95% CI: 0.23 to 0.45, p < 0.05), lower infectious complications (OR: 0.29, 95% CI: 0.17 to 0.51, p < 0.05), lower bacteraemia (OR: 0.18, 95% CI: 0.07 to 0.42, p < 0.05)” compared to urgent-start HD. Conclusions:Our findings indicate that among patients with ESRD, those undergoing urgent-start PD have lower risks during the follow-up period compared to those receiving urgent-start HD. USPD is associated with significantly reduced all-cause mortality, overall complications, infectious complications, non-infectious complications, and bacteremia incidence. The results indicate that USPD could potentially function as an appropriate replacement for USHD. However, further high-quality clinical studies still are necessary to substantiate this conclusion.

Journal Section:
Peritoneal Dialysis
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S. Karger AG, Basel
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2025
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