Continuous ambulatory peritoneal dialysis (CAPD) versus hospital or home haemodialysis for end-stage renal disease in adults.
BACKGROUND
Renal replacement therapy (RRT) with dialysis and transplantation is the only means of sustaining life for patients with end-stage renal disease (ESRD). Although transplantation is the treatment of choice, the number of donor kidneys are limited and transplants may fail. Hence many patients require long-term or even life-long dialysis. Continuous ambulatory peritoneal dialysis (CAPD) is an alternative to hospital or home haemodialysis for patients with ESRD.


OBJECTIVE
To assess the benefits and harms of CAPD versus hospital or home haemodialysis for adults with ESRD.


METHODS
We searched the Cochrane Controlled Trials Register (Cochrane Library, Issue 2, 2002), the Cochrane Renal Group's Specialised Register (May 2002), MEDLINE (1966 - May 2002), EMBASE (1980 - May 2002), BIOSIS, CINHAL, SIGLE and NRR without language restriction. Reference lists of retrieved articles and conference proceedings were searched and known investigators and biomedical companies were contacted.


METHODS
Randomised controlled trials (RCTs) or quasi-RCTs comparing CAPD to hospital or home haemodialysis for adults with ESRD were to be included.


METHODS
Two reviewers were to independently assess the methodological quality of studies. Data was to be abstracted from included studies onto a standard form by one reviewer and checked by another. Statistical analyses were to be performed using the random effects model and the results to be expressed as relative risk (RR) with 95% confidence intervals (95% CI).


RESULTS
Despite extensive searching, no RCTs or quasi-RCTs were identified.


CONCLUSIONS
Data are not available to allow conclusions to be drawn about the relative effectiveness of CAPD compared with hospital or home haemodialysis for adults with ESRD. Efforts should be made to start and complete adequately powered RCTs, which compare the different dialysis modalities.
Vale
L
L
Health Economics Research Unit/Health Services Research Unit, University of Aberdeen, Medical School Building, Foresterhill, Aberdeen, UK, AB25 2ZD.
Cody
J
J
Wallace
S
S
Daly
C
C
Campbell
M
M
Grant
A
A
Khan
I
I
Donaldson
C
C
MacLeod
A
A
D000328:Adult; D006437:Hemodialysis, Home; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory