GRADE profile 81Effectiveness of sequences and impact of switching – adverse events

Quality assessmentSummary of findingsQuality
No of studiesStudy designLimitationsInconsistencyIndirectnessImprecision
Adults and children
Adverse events
Badve 2006
Report from national registryNo serious limitationsNot assessableaNo serious indirectnessSome serious imprecisionbAdjusted weighted HR for peritonitis in PD after transplant vs PD after failure of native kidneys 0.92 (95% CI 0.72 to 1.16), after adjustment for gender, age, race, comorbidities, BMI, smoking, time from commencement of RRT to PD, country of residence; 0.88 (95% CI 0.60 to 1.30), with addition of peritoneal transport statusVERY LOW
Adverse events
Guo 2003
Report from national registryNo serious limitationsNot assessableaNo serious indirectnessNot assessablecInfections causing transfer to HD
Patients transferring to PD after a failed transplant vs transferring to HD because of infection (p = ns) were higher than in those new to dialysis (approx 7.3% vs 4.9%; p = 0.05) and similar in those who had transferred from HD (approx 7.3% vs 5.9%)

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


Imprecise based on 10% threshold (downgraded one level).


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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