Article type
Year
Abstract
Background: Dialysis is a therapy designed to filter toxic substances from the blood of patients with kidney failure. A dialysis membrane is a core component of this treatment. Dialysis membranes can be made from cellulose, modified cellulose or synthetic materials, with great variance in the cost of the membranes. As of yet, no evidence exists to indicate that synthetic materials are superior to conventional materials.
Objectives: To assess the different dialysis membranes in terms of effectiveness, safety, social acceptance and health economics.
Methods: All randomised or quasi-randomised clinical trials comparing the effectiveness of different dialysis membranes were included. All safety and economic studies were included regardless of study quality. Comprehensive searches of MEDLINE (1966-2002/3), EMBASE (1984-2001/12), Cochrane Controlled Trials Register, Cancerlit (1996-2001/9), Biological Abstract (1990-1996), Life Science collection (1982-1995), Chinese Biomedical Literature Database(CBM)(1979-2001), China Journal Databases of Vip (VIP) (1989-1999), China National Knowledge Infrastructure (CNKI)(1989-2001) and Engineering Information (EI) Compendex Web (1970-1999) were conducted. Two reviewers independently screened the identified studies, and any disagreement between them was resolved through discussion.
Results: One systematic review, three health technology assessments and 218 controlled clinical trials (CCT) were included. Comparisons mainly focused on the effects of synthetic and modified-cellulose membranes on patients with acute renal failure (ARF), chronic renal failure (CRF), end-stage renal disease (ESRD), renal transplantation, drug and chemical poisoning, heroin addiction and autoimmune diseases. Fifty-six studies assessed the effectiveness of these membranes, seventy-six assessed their safety and five assessed their health economics. Effectiveness was measured in terms of mortality, life quality, renal clearance, recovery of renal function, et al. Individual case reports detailing serious adverse reactions, such as amyloidosis, thrombocytopenia, malnutrition, anemia, cardiovascular disease and other bio-incompatibility (BICM) reactions, were also included.
Conclusions: Our observations at this early stage indicate that much research is yet needed to adequately assess the differences between natural and synthetic dialysis membranes. Our future research will be based upon four criteria: the results of our initial research, the degree to which individual doctors and patients are able to discern differences in dialysis membranes, the prices of the various membranes and the currently debated ideas as to which membrane is best suited to treating which indications of hemodialysis. Further results will be reported soon.
Objectives: To assess the different dialysis membranes in terms of effectiveness, safety, social acceptance and health economics.
Methods: All randomised or quasi-randomised clinical trials comparing the effectiveness of different dialysis membranes were included. All safety and economic studies were included regardless of study quality. Comprehensive searches of MEDLINE (1966-2002/3), EMBASE (1984-2001/12), Cochrane Controlled Trials Register, Cancerlit (1996-2001/9), Biological Abstract (1990-1996), Life Science collection (1982-1995), Chinese Biomedical Literature Database(CBM)(1979-2001), China Journal Databases of Vip (VIP) (1989-1999), China National Knowledge Infrastructure (CNKI)(1989-2001) and Engineering Information (EI) Compendex Web (1970-1999) were conducted. Two reviewers independently screened the identified studies, and any disagreement between them was resolved through discussion.
Results: One systematic review, three health technology assessments and 218 controlled clinical trials (CCT) were included. Comparisons mainly focused on the effects of synthetic and modified-cellulose membranes on patients with acute renal failure (ARF), chronic renal failure (CRF), end-stage renal disease (ESRD), renal transplantation, drug and chemical poisoning, heroin addiction and autoimmune diseases. Fifty-six studies assessed the effectiveness of these membranes, seventy-six assessed their safety and five assessed their health economics. Effectiveness was measured in terms of mortality, life quality, renal clearance, recovery of renal function, et al. Individual case reports detailing serious adverse reactions, such as amyloidosis, thrombocytopenia, malnutrition, anemia, cardiovascular disease and other bio-incompatibility (BICM) reactions, were also included.
Conclusions: Our observations at this early stage indicate that much research is yet needed to adequately assess the differences between natural and synthetic dialysis membranes. Our future research will be based upon four criteria: the results of our initial research, the degree to which individual doctors and patients are able to discern differences in dialysis membranes, the prices of the various membranes and the currently debated ideas as to which membrane is best suited to treating which indications of hemodialysis. Further results will be reported soon.