Meta-analysis of Cohort Studies on Clinical Efficacy of Icodextrin Peritoneal Dialysate

Abstract

Objective To evaluate the effect of real-world practices for icodextrin peritoneal dialysis solution on patients with end-stage renal disease (ESRD) by Meta-analysis. Methods The PubMed and Embase databases were systematically searched for real-world research literature on icodextrin peritoneal dialysate in the treatment of ESRD patients, and RevMan5.4 statistical software was used for Meta-analysis. Results and Conclusion 12 studies with 114 656 patients were included. Meta-analysis results showed that icodextrin peritoneal dialysis had good effects on mortality [RR = 0.72, 95% CI (0.62, 0.83), P < 0.001], congestive heart failure [RR = 0.67, 95% CI (0.52, 0.87), P = 0.003], and risk of new-onset diabetes [RR = 0.65, 95% CI (0.49, 0.86), P = 0.003], which was consistent with the Meta-analysis based on clinical trials. Meanwhile, there was no significant difference in PD technical failure rate [RR = 0.67, 95% CI (0.44, 1.00), P = 0.05], peritonitis [RR = 1.02, 95% CI (0.99, 1.05), P = 0.14], cardiovascular and cerebrovascular diseases [RR = 0.79, 95% CI (0.59], 1.05), P = 0.10], coronary artery disease [RR = 0.99, 95% CI (0.92, 1.07), P = 0.80], stroke [RR = 0.86, 95% CI (0.66, 1.10), P = 0.23], and atrial fibrillation [RR = 0.73, 95% CI (0.37, 1.44), P = 0.36]. However, it might increase the risk of hypertension [RR = 1.05, 95% CI (1.03, 1.07), P < 0.001]. Therefore, icodextrin can effectively reduce the risk of mortality, congestive heart failure, and new-onset diabetes, which is beneficial to ESRD patients.

Keywords

icodextrin peritoneal dialysis fluid / peritoneal dialysis / end-stage renal disease / mortality / Metaanalysis

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