Comparison of nocturnal hemodialysis and conventional hemodialysis for end-stage renal disease: A meta-analysis and systematic review

Objective To systematically evaluate and compare the efficacy of nocturnal hemodialysis and conventional hemodialysis in the treatment of end stage renal disease. Methods Pubmed, Cochrane Library, EMBASE, and the Chinese SinoMed database were systematically searched for relevant articles. The Rev Man 5.3 and STATA 12.0 software were used for meta-analysis. Results A total of 21 studies consisting of 22 441 patients were analyzed, including 2 810 cases in the nocturnal hemodialysis group and 19 631 cases in the conventional hemodialysis group. The pooled results demonstrated that nocturnal hemodialysis was significantly associated with prolonged overall survival (hazard ratio, 0.56, 95% CI, 0.43 to 0.73), better control of left ventricular mass (Mean Difference, MD, -19.59 g/m², 95% CI, -30.53 to -8.65) and blood pressuresystolic pressure, MD, -6.88 mmHg (1 mmHg=0.133 kPa); 95% CI, -11.54 to -2.23; diastolic pressure, MD:-2.80 mmHg; 95% CI, -5.40 to -0.19, higher levels of albumin (MD:1.14 g/L; 95%CI, 0.33 to 1.94) and hemoglobin (MD:2.53 g/L, 95% CI:0.66 to 4.40) when compared with conventional hemodialysis for end stage renal disease patients. Conclusion For end stage renal disease patients, nocturnal hemodialysis will be a preferred choice in comparison with conventional hemodialysis.