GRADE profile 79Effectiveness of sequences and impact of switching – technique failure or switch (adults)

Quality assessmentSummary of findingsQuality
No of studiesStudy designLimitationsInconsistencyIndirectnessImprecision
Adults
Technique survival or switch
2
Guo 2003
Mujais 2006
Report from national registryNo serious limitationsNot assessableaNo serious indirectnessNot assessablebTransfer to HD similar across all groups, with transfer being highest in the first year of dialysis (p < 0.0001)
Patients on PD transferred from HD appeared to have similar rates of transfer to HD to patients with a failed transplant (no p value or statistical analysis reported)
1 yr transfer to HD new to PD 19.60%; 2 yr 16.13%; 3 yr 15.75%
1 yr transfer to HD after transfer from HD 23.12%; 2 yr 17.33%; 3 yr 17.61%
1 yr PD transfer to HD after failed transplant 17.61%; 2 yr 21.37%; 3 yr 12.34%
Technique survival was similar across all groups
1 yr technique survival new to PD 82.74%; 2 yr 69.03%; 3 yr 57.39%; 4 yr 52.08%
1 yr technique survival post transfer from HD 74.74%; 2 yr 64.55%; 3 yr 54.92%; 4 yr 48.72%
1 yr technique survival after failed transplant 77.21%; 2 yr 64.22%; 3 yr 53.72%; 4 yr 47.75%
There were differences in the distribution of reasons for change across groups (p < 0.007), with fewer changes due to psychosocial reasons in the failed transplant group
VERY LOW
a

This sequence or comparison reported in one study only (downgraded one level).

b

Confidence intervals only reported for some studies (and outcomes) (downgraded one level).

From: 3, How this guideline was developed

Cover of Peritoneal Dialysis
Peritoneal Dialysis: Peritoneal Dialysis in the Treatment of Stage 5 Chronic Kidney Disease.
NICE Clinical Guidelines, No. 125.
Centre for Clinical Practice at NICE (UK).
Copyright © 2011, National Institute for Health and Clinical Excellence.

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