title: Effect of Nocturnal Hemodialysis versus Conventional Hemodialysis on End-Stage Renal Disease: A Meta-Analysis and Systematic Review.
abstract: OBJECTIVE
  The purpose of this study is to assess the efficacy and safety of nocturnal hemodialysis on end-stage renal disease (ESRD) patients.
  
  
  METHODS
  We searched Medline, EmBase, and the Cochrance Central Register of Controlled Trials for studies up to January 2016. Analysis was done to compare variant outcomes of different hemodialysis schedules, including mortality, cardiovascular-associated variables, uremia-associated variables, quality of life (QOL), side-effects, and drug usage.
  
  
  RESULTS
  We collected and analyzed the results of 28 studies involving 22,508 patients in our meta-analysis. The mortality results in this meta-analysis indicated that the nocturnal hemodialysis (NHD) group was not significantly different from conventional hemodialysis (CHD) group (Mortality: OR: 0.75; 95% confidence intervals (CIs): 0.52 to 1.10; p = 0.145), but the CHD group had significantly fewer number of hospitalizations than the NHD group (OR: 1.54; 95%CI: 1.32 to 1.79; p<0.001). NHD was superior to CHD for cardiovascular-associated (left ventricular hypertrophy [LVH]: SMD: -0.39; 95%CI: -0.68 to -0.10; p = 0.009, left ventricular hypertrophy index [LVHI]: SMD: -0.64; 95%CI: -0.83 to -0.46; p<0.001) and uremia-associated intervention results (Serum albumin: SMD: 0.89; 95%CI: 0.41 to 1.36; p<0.001). For the assessment of quality of life, NHD treatment significantly improved the patients' QOL only for SF36-Physical Components Summary (SMD: 0.43; 95%CI: 0.26 to 0.60; p<0.001). NHD intervention was relatively better than CHD for anti-hypertensive drug usage (SMD: -0.48; 95%CI: -0.91 to -0.05; p = 0.005), and there was no difference between groups in our side-effects assessment.
  
  
  CONCLUSIONS
  NHD and CHD performed similarly in terms of ESRD patients' mortality and side-effects. NHD was superior to CHD for cardiovascular-associated and uremia-associated results, QOL, and drug usage; for number of hospitalizations, CHD was relatively better than NHD.
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Fangjie
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Clinical Medicine, China Medical University, Shenyang, Liaoning, China.
authors.forename: Yiting
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Tianhua
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Blood Purification Center, Liaoning Electric Power Center Hospital, Shenyang, Liaoning, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Lining
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Nephrology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yao
mesh_terms: D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000379:methods*