关键词: 腹膜透析, 生物相容性, 随机对照研究, 预后, 残余肾功能

Abstract:

[Abstract ] Objective To assess the effect of neutral pH, low-GDP peritoneal dialysis solutions (NpHLGDPPDF) on clinical outcome in peritoneal dialysis (PD) patients with meta-analysis of parallel randomized controlled trials (RCTs). Methodology: Studies were identified by systematic search of peer-reviewed publications in Medline, EMBASE and Cochrane library database. All of the RCTs that compared the clinical outcome between NpHLGDP and conventional PDF were eligible. According to the inclusion and exclusion criteria, data of the included studies were extracted, and the methodological quality was evaluated. Then meta-analysis was performed using RevMan 5.2 and Stata 12.0 software. Results：A total of 16 RCTs involving 1546 patients was included. The quality od studies was generally poor. The results of meta-analysis showed that compared to conventional PDF, use of NpHLGDPPDF resulted in more urine outputs (8 trials; 699 patients; WMD 131ml, 95%CI 64~197); a trend to reduce gradually the decline of GFR during the whole follow-up (SMD, -0.01、0.12、0.21ml/min of 12、18 and 24 months or more than respectively). However, it didn’t improve the patient and technique survival. NpHLGDPPDF was associated non-significant 16% peritonitis risk reduction (9 trials; 727 patients; Risk Ratio, 0.84, 95% 0.67~1.05). Meta-regression analysis showed that peritonitis risk was negatively associated with sample numbers (β= -0.006, P=0.01). Subgroup analyses showed that the risk of peritonitis was significantly lower in several studies of which PD patient was oriental and used ACEI/ARB. Conclusion The use of NpHLGDPPDF resulted in more urine outputs while failed to improve the clinical outcome in PD patients.

Key words: peritoneal dialysis, biocompatible, randomized controlled trials, clinical outcome, residual renal function