Dialysis Modality Choice in Diabetic Patients With ESRD
Dialysis Modality Choice in Diabetic Patients With ESRD
MEDLINE, EMBASE and CENTRAL databases were searched until February 2014 for English-language articles without time or methodology restrictions through focused and highly sensitive search strategies (Supplementary Table S1 http://ndt.oxfordjournals.org/content/30/2/310/suppl/DC1). Supplementary articles were added by manual search.
We planned to include any randomized or non-randomized controlled trial, single-arm, prospective or retrospective observational study comparing any kind of peritoneal dialysis (automated peritoneal dialysis APD, continuous ambulatory peritoneal dialysis CAPD) to any kind of haemodialysis (conventional HD, haemofiltration HF, haemodiafiltration HDF, daily HD) as first renal replacement therapy in diabetic patients with ESKD. Studies were considered without follow-up duration restrictions. Diabetes (type I or II) was considered either as being the cause of ESKD or a superimposed condition. Studies where a well-defined part of the population fulfilled the above criteria were included in the review. Outcomes of interest were survival, quality of life, major morbid events (including but not limited to myocardial infarction, stroke, amputation and loss of vision), hospital admissions, deterioration of residual renal function when already on dialysis, minor morbid events (including but not limited to hypoglycaemia, delayed wound healing, infection, visual disturbances and pain), functional status, glycaemic control, access to transplantation and technique survival. Studies were excluded if: (i) outcomes were not reported for diabetics separately; (ii) not providing longitudinal data on any of the above mentioned outcomes; (iii) not directly comparing HD with PD. Case reports, reviews, editorials and letters were excluded as well, although they were screened as potential sources of additional references. Selection of relevant studies was independently performed by two authors (C.C. and D.B.). Discrepancies were solved collegially.
We used the Newcastle–Ottawa Scale to assess the study quality for observational studies. This scale considers a quality score calculated on the basis of three major issues: study participants (0–4 points), adjustment for confounding (0–2 points) or ascertainment of the exposure or outcome of interest (0–3 points) with a maximum score of 9 points which represents the highest methodological quality.
Data extraction and analysis were performed by two reviewers independently (C.C. and D.B.). In studies considering mixed populations, the subgroup of patients with documented diabetes was described only if corresponding data were available.
Materials and Methods
Data Source and Search Strategy
MEDLINE, EMBASE and CENTRAL databases were searched until February 2014 for English-language articles without time or methodology restrictions through focused and highly sensitive search strategies (Supplementary Table S1 http://ndt.oxfordjournals.org/content/30/2/310/suppl/DC1). Supplementary articles were added by manual search.
Study Selection
We planned to include any randomized or non-randomized controlled trial, single-arm, prospective or retrospective observational study comparing any kind of peritoneal dialysis (automated peritoneal dialysis APD, continuous ambulatory peritoneal dialysis CAPD) to any kind of haemodialysis (conventional HD, haemofiltration HF, haemodiafiltration HDF, daily HD) as first renal replacement therapy in diabetic patients with ESKD. Studies were considered without follow-up duration restrictions. Diabetes (type I or II) was considered either as being the cause of ESKD or a superimposed condition. Studies where a well-defined part of the population fulfilled the above criteria were included in the review. Outcomes of interest were survival, quality of life, major morbid events (including but not limited to myocardial infarction, stroke, amputation and loss of vision), hospital admissions, deterioration of residual renal function when already on dialysis, minor morbid events (including but not limited to hypoglycaemia, delayed wound healing, infection, visual disturbances and pain), functional status, glycaemic control, access to transplantation and technique survival. Studies were excluded if: (i) outcomes were not reported for diabetics separately; (ii) not providing longitudinal data on any of the above mentioned outcomes; (iii) not directly comparing HD with PD. Case reports, reviews, editorials and letters were excluded as well, although they were screened as potential sources of additional references. Selection of relevant studies was independently performed by two authors (C.C. and D.B.). Discrepancies were solved collegially.
Quality Assessment
We used the Newcastle–Ottawa Scale to assess the study quality for observational studies. This scale considers a quality score calculated on the basis of three major issues: study participants (0–4 points), adjustment for confounding (0–2 points) or ascertainment of the exposure or outcome of interest (0–3 points) with a maximum score of 9 points which represents the highest methodological quality.
Data Extraction and Analysis
Data extraction and analysis were performed by two reviewers independently (C.C. and D.B.). In studies considering mixed populations, the subgroup of patients with documented diabetes was described only if corresponding data were available.
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