Emergency peritoneal dialysis in patients with end-stage renal disease: a Meta-analysis

Objective To explore the safety and patient outcomes of emergency peritoneal dialysis(PD)among individuals with end-stage kidney disease compared to those with conventional peritoneal dialysis by meta-analysis.Methods The databases of PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,WanFang and VIP were searched by computer up until January 2020.Cohort studies were examined for comparing the safety and patient outcomes of emergency PD(<14 days post-catheterization)to those with conventional PD(≥14 days post-catheterization),two researchers independently screened the literature,extracted data and evaluated literature quality.The enrolled studies were conducted for Meta-analysis with RevMan5.3 software.Results Eight studies involving 1,446 patients were identified.Compared with conventional PD,mortality rateRR=1.48;95%CI(0.71-3.08);Z=1.04,P=0.30,technical survival rateRR=0.98;95%CI(0.92-1.04);Z=0.59,P=0.55,infectious complicationsRR=1.07;95%CI(0.83-1.37);Z=0.50,P=0.62and mechanical complicationsRR=1.49;95%CI(0.90-2.45);Z=1.56,P=0.12of emergency PD showed no statistical difference.The subgroup analysis of mechanical complications revealed that emergency PD was associated with a higher leakage rateRR=3.73;95% CI(1.79-7.77);Z=3.52,P=0.0004.Conclusion No significant inter-group difference exists in mortality,technical survival rate or incidence of infectious complications.However,emergency PD may elevate the risk of leakage.