Dialysis modality and mortality in polycystic kidney disease

Introduction: Identifying the appropriate modality between hemodialysis (HD) and peritoneal dialysis (PD) is an unresolved issue in polycystic kidney disease (PKD) patients. This study aims to illustrate whether the mortality and survival are different among individuals receiving HD comparing PD. Methods: We searched PubMed, EMBASE, and China National Knowledge Infrastructure about cohort studies involving PKD patients with end stage renal disease and comparing HD with PD. We calculated pooled risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous data. Primary outcomes were the mortality and survival (not the technique survival). Findings: Eight studies involving 7685 PKD patients were identified. There were no significant differences in mortality (RR 1.06, 95% CI 0.84-1.34, P=0.61) and 5-year survival rate (RR 0.99, 95% CI 0.80-1.22, P=0.90) between HD and PD. PD was not associated with higher risks of abdominal infections and hernia. However, HD was associated with a higher incidence of renal cyst hemorrhage (RR 2.53, 95% CI 1.05-6.12, P=0.04). Discussion: There are no significant differences of mortality and survival between different dialysis modalities in PKD. PD may be as successful as HD for PKD patients receiving renal replacement therapy.