Summary of findings 1. Summary of findings.
| Urgent‐start peritoneal dialysis versus haemodialysis initiated with a catheter for patients with chronic kidney disease | |||||
|
Patient or population: people with CKD Settings: community Intervention: USPD Comparison: HD initiated with a central venous catheter | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with USHD | Risk with USPD | ||||
|
Bacteraemia up to 6 months |
151 per 1,000 |
20 per 1,000 (6 to 62) |
RR 0.13 (0.04 to 0.41) |
301 (2) | ⊕⊕⊝⊝ LOW1 |
|
Peritonitis up to 6 months |
7 per 1,000 |
13 per 1,000 (2 to 98) |
RR 1.78 (0.23 to 13.62) |
301 (2) | ⊕⊝⊝⊝ VERY LOW2 |
| Exit‐site or tunnel infection | 18 per 1,000 |
71 per 1,000 (24 to 216) |
RR 3.99 (1.32 to 12.05) |
419 (1) | ⊕⊝⊝⊝ VERY LOW2 |
| Exit‐site bleeding | 37 per 1,000 |
4 per 1,000 (0 to 85) |
RR 0.12 (0.01 to 2.33) |
178 (1) | ⊕⊝⊝⊝ VERY LOW2 |
| Catheter malfunction | 151 per 1,000 |
39 per 1,000 (11 to 137) |
RR 0.26 (0.07 to 0.91) |
597 (2) | ⊕⊝⊝⊝ VERY LOW3 |
|
Catheter re‐adjustment up to 60 months |
373 per 1,000 |
48 per 1,000 (0 to 1,000) |
RR 0.13 (0.00 to 18.61) |
225 (2) | ⊕⊝⊝⊝ VERY LOW3 |
|
Technique survival up to 6 months |
526 per 1,000 |
621 per 1,000 (458 to 847) |
RR 1.18 (0.87 to 1.61) |
123 (1) | ⊕⊝⊝⊝ VERY LOW2 |
| Home dialysis | ‐ | ‐ | ‐ | No studies | ABSENT |
|
Death (any cause) up to 24 months |
204 per 1000 |
139 per 1,000 (90 to 218) |
RR 0.68 (0.44 to 1.07) |
820 (5) | ⊕⊝⊝⊝ VERY LOW2 |
|
Hospitalisation up to 6 months |
579 per 1,000 |
683 per 1,000 (515 to 897) |
RR 1.18 (0.89 to 1.55) |
123 (1) | ⊕⊝⊝⊝ VERY LOW2 |
| *The risk in the USPD group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio; HD: haemodialysis; USHD: urgent‐start HD; USPD: urgent‐start peritoneal dialysis | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1downgraded for observational studies
2 downgraded for observational studies, imprecision due to small number of events
3 downgraded for observational studies and imprecision due to small number of events, and inconsistency