Comparison of the quality of life and biochemical characteristics of patients undergoing hemodialysis and peritoneal dialysis: a systematic review and meta-analysis.

backgroundEnd-stage kidney failure (ESKF) requires kidney replacement therapy (KRT), which has a significant effect on the quality of life (QoL) of patients. Globally, well-established treatment options for ESKF include HD, PD, and kidney transplantation. Each has a unique effect on a patient's QoL in terms of their physical, mental, and social health. The objective of this study was to evaluate and compare the QoL of patients undergoing PD and HD by utilizing the 36-item Short Form Health Survey (SF-36), EuroQoL-5-dimension (EQ-5D), and WHOQOL-BREF questionnaires.

methodsWe performed a comprehensive review and meta-analysis by identifying relevant research through the use of ScienceDirect, CINAHL, MEDLINE, and Google Scholar. These studies examined patients with ESKF who were undergoing either HD or PD and reported changes in QoL and biochemical characteristics. If heterogeneity was present, we calculated and pooled the standardized mean differences (SMDs) in QoL among modalities via a random effects model.

resultsThis analysis included twenty-five (25) studies that examined the QoL and biochemical characteristics of a total of 5,440 participants. Among these participants, 3465 (63.75%) were receiving HD, and 1975 (36.25%) were receiving PD. The QoL instruments assess a variety of effects. However, these studies demonstrate that PD consistently performs better than HD in multiple assessment components, including for burdens of kidney disease, general health, mental health, and emotional. Nevertheless, there was no significant difference in the QoL scores regarding cognitive ability, energy levels, physical health, patient satisfaction, psychology, social interaction, emotional well-being, sexual functioning, or sleeping patterns between these modalities.

conclusionThe study's findings show that patients with PD have a higher QoL in comparison to those with HD. Despite reports of enhanced QoL among PD patients, their global prevalence remains relatively low. Therefore, healthcare professionals should prioritize the development and implementation of strategies for ESKF patients, considering PD as the primary treatment. The results suggest a trend favoring PD over HD in various aspects of QOL. However, the significant heterogeneity and the lower number of PD patients require careful interpretation of these findings.