Critical Evaluation Of Litrature

Running head: CRITICAL EVALUATION OF LITERATURE
CRITICAL EVALUATION OF LITERATURE
Name of the Student
Name of the University
Author Note

1CRITICAL EVALUATION OF LITERATURE
Introduction
Chronic kidney disease is one of the rising mortality factors among the human
population. Studies have shown that this increase in chronicity of the disease leads to imbalance
in the in kidney function along with high death rate which rise more after discharge. The
condition detoriates the overall quality of life. The primary main of the below paper is to
critically evaluate papers based on comparison among home hemodialysis and center
hemodialysis in providing quality life who was from suffering end-stage renal disease by using
PICOT format.
A systemic review and Meta-analysis of health related quality of life in home
dialysis patients compared to in-center hemodialysis
Bonenkamp et al. performed a systemic review and meta-analysis to discriminate among
in-center hemodialysis (ICHD) and home dialysis patients in relation with enhancement of life
between the year 2007 and 2019. Most studies were directed on peritoneal dialysis patients and
subgroup analysis revealed that home dialysis patients in Western European had greater health
related quality of life score (HRQoL) than Latin American patients. Mental health associated
issue had no difference in all evaluations (Bonenkamp et al., 2020)
The databases were collected from different search engines like Pubmed, Cochrane
Library and EMBASE between the year of 2007 and 2019. Here, the sample collection time was
very little to come into a result. Though randomized controlled trails and observational studies
were followed in time of examination, the result showed high heterogeneity among studies. This

2CRITICAL EVALUATION OF LITERATURE
study revealed ordinary to high risk of bias. The quality of study design was poor. For some
studies it was completely unknown in the interview that if any service providers were proficient
to evaluate HRQol . It hints to potential bias in outcome evaluation.
Patients receiving frequent hemodialysis have better health-related quality of
care patients receiving conventional hemodialysis:
Garg et al. completed two types of medical trial to evaluate the effect of frequent
hemodialysis in association with traditional method. The Regular trial arbitrarily allotted 245
patients to obtain both the aspect of frequent and conventional strategies. The nocturnal trial
randomly assigned 87 patients with the same criteria. The outcome was measured by the
differences in the treatment groups in one-year change in HRQol and evaluated by the method of
linear-mixed effects replicas. In center-dialysis facility offered better HRQoL with regular in
relation with conventional hemodialysis (Garg et al., 2017).
The study design with additional and elimination criteria of both the trials were correctly
discussed by the method of randomization process, data collection methods, and baseline
characteristics. Since the patients for both the nocturnal and daily trial were assigned randomly,
the biasness of the results was avoided.
Choosing home hemodialysis: a critical review of patient outcomes
A systemic review was performed by applying different databases like PubMed,
Cochrane Library to compare the result of Home hemodialysis (HHD) and ICHD in terms of

3CRITICAL EVALUATION OF LITERATURE
survival; health related quality of life, hospitalization. The result indicated enhanced values in
the patients who chose HHD (Miller et al., 2018).
In this paper, the statistical data is not described in case of hospitalization. Though
vigorous studies are performed to evaluate the impact and effects of HHD; large, randomized,
prospective trials are missing in this article. Therefore, the chances of biasness are present.
Presence of population variance, sample sizes, and the design of the study diminishes the
probability of performing quantitative meta-analysis rather performs a composed qualitative
analysis. Additional factors that could affect the studies including performance of health
professionals, patient motivation, and vascular access type are not considered. The few
randomized experiments were also limited by several aspects like small size, duration of follow-
up, prevalence of false-positive findings that were creating generalization apart from study
population.
Longitudinal patterns of health related quality of life and dialysis modality; a
national cohort study
A cohort survey study in adult patients was performed in national level between 1/2013
and 6/2015 showed that there were variations in several phases in the patients who shifted
modality. Health Related Quality of Life was estimated by the Kidney Disease and Quality of
Life (KDQOL) (Eneanya et al., 2019).
In this study, some confusing variables were present that increase the chances of bias into
the evaluation. This review also established different types of HRQoL by dialysis. However, this
study cannot verify the reason as this is an observational study. The study population was also

4CRITICAL EVALUATION OF LITERATURE
lesser to assess the patterns of HRQoL among patients with changes modality. This article was
only responsive against the patient who recovered from this disease and also completed the
assessment. This factor hindered the generalizability of the experiment result. Another limitation
of this article was the two distinct communities were grouped as one setting. Therefore, it is
incapable to distinguish shifts among the two methods and possible outcomes on HRQoL.
Improved long-term survival with home hemodialysis compared with
institutional hemodialysis and peritoneal dialysis: a matched cohort study:
Using the Swedes Renal Registry from 1991 to 2012 and survival evaluations were
completed to match the patients between HHD and Institutional Hemodialysis (IHD) or
Peritoneal Dialysis (PD). Total 152 patients with HHD were harmonized with 456 PD and 608
IHD patients. Patients with HHD showed long period of survival compared with IHD and PD
(Rydell et al., 2019).
The study is designed retrospectively and it has limitation. There is a prevalence of
confusing variables for example smoking and socio economic factors. There was absence of info
about GFR and supplementary laboratory experiments at the time of dialysis since this was a
registry study. In this study, the statistical analysis was performed very accurately by using the
STATA software version 12. Kalpan Meier curves and multivariable Cox regression analyses
were used for the patient and renal graft survival analysis equally. However, this study possesses
several benefits. The similarity was accurate and effective and the registry data created the
comorbidity score. This experiment also showed completeness of the diagnoses which helps to
get appropriate result.

5CRITICAL EVALUATION OF LITERATURE
Home versus in center hemodialysis for end stage kidney disease
The objective of this learning was to analyze the benefits and problems of home
hemodialysis against institutional hemodialysis in adults with ESRD up to 31st October 2014. In
this study, the data was collected by two agents to encounter study biasness and patient-centered
outcomes. Meta –analyses were performed because of inadequate data (Palmer et al., 2014).
The data from the study revealed the effectiveness of the home hemodialysis compared to
institutional dialysis. In this cross-over study, the outcome information was incomplete and was
not accessible at the starting of the care process. This increases the prevalence of bias since the
dialysate components are varied between two different treatment procedures. Comparison of the
data was restricted to a minor study as applicants were newer than usual hemodialysis peoples.
Randomized statistics were selected still it was restricted to a small, solo centered learning.
Biases may occur when the process of analysis was valued using standard Cochrane
Methodology that can bind the validation of result.
The influence of different dialysis modalities on the quality of life of patients
with end stage renal disease: a systematic literature review
Ho & Li aims to find the relationships of various dialysis methodologies with HRQoL in
the patient with hemodialysis, peritoneal dialysis according to their psychological, physiological,
and social activity along with the disease symptoms by the method of systematic review using
the databases like CINAHL, Medline, and PubMed between the year 1997 to 2016. The result
suggested that no substantial variances in HRQoL between HD and PD patient (Ho & Li, 2016).

6CRITICAL EVALUATION OF LITERATURE
The main disadvantages of this are reviewed studies which implemented cross-sectional
strategies to quantity at solo time facts. It is difficult to evaluate the relations between HD and
PD patients. The author also rejected non-English literatures that could be another probable
language bias. The vast population size helps to evaluate the result accurately. The researchers
used different types of questionnaire and different study design as they thought the outcome
would be clinically dissimilar. Since different studies use different methodologies the authors did
not perform the meta-analysis.
Hajji & Laudanski performed a review on effectiveness of home hemodialysis treatment
and underutilized in United States patients. They utilized databases such as PubMed,
Medline,Google Scholar. The paper was based on meta-analysis or original studies. The outcome
has directed the different causes that affect underutilization (Hajji & Laudanski, 2017).
The study was limited to one country that is US. The authors selected those papers that
were written only in English language. Another criterion of the researches was completed on US
patients. The authors did not consider the patient outside the US as they found that was not
relevant to the objective of the study. They reviewed the kidney disease education that will be
helpful to guide the patients who are going for dialysis. Thus is will increase home dialysis rather
than conventional HD. This method is appropriate for this study. After performing several
studies, the author perfectly demonstrated that home hemodialysis has benefited quality of life.
United States Renal Data System has reported the event, risk, patient features and care
procedures in US. This chapter utilized database from the Centers for Medicare & Medicaid
Services (CMS) and special evaluations based on the USRDS ESRD database.

7CRITICAL EVALUATION OF LITERATURE
The article found that the age groups of these incidences are generally stable but for the
age group of 65-74, the ESRD rates are lowest. They evaluated the prevalence of disease across
the region. However, the prediction was difficult to detect the geographical patterns in some
areas.
Fluck et al. surveyed on the topic of nephrologists perspectives on dialysis treatment.
This was designed on the basis of online questionnaire by qualitative research on the patients of
greater than 25 adults. The survey demonstrated that most common type of dialysis are
peritoneal and HD that are seen in the patients. They also proposed that HD and high dose of HD
provide better health to the patient (Fluck, Fouque & Lockridge, 2014).
The study results were biased by the experiences of US nephrologists, as the number is three
times greater than other countries. The study noted that the studies did not include reactions from
Australia and New Zealand, where home therapies are common. Larger amount of data along
with appropriate statistical analysis also improved to expose worldwide practice and treatment.
The survey analysis may itself bias the study population in some way.
Conclusion
The whole survey revealed that Acute Kidney Injury (AKI) happens in more than half of
the Intensive Care Unit patients. This study also showed that, the severity of this can increase
mortality and the patients confront with misbalance in kidney function at the time of discharge
from hospital. A systemic review and meta-analysis were performed to distinguish among in-
center hemodialysis (ICHD) and home dialysis patients in relation with enhancement of life
between the year 2007 and 2019. Most studies were directed on peritoneal dialysis patients and
subgroup analysis revealed that home dialysis patients in Western European had greater health

8CRITICAL EVALUATION OF LITERATURE
related quality of life score (HRQoL) than Latin American patients. Mental health associated
issue had no difference in all evaluations. The data from the study revealed the effectiveness of
the home hemodialysis compared to institutional dialysis. These literature review assessed the
efficacy of home-based dialysis compared to in-center hemodialysis in providing quality of life
and to enable patients and their family in the decision making of selecting home hemodialysis as
a care option. The study revealed that home-based dialysis has benefits over in-center dialysis
with regard to patient suitability, reduced cost, and enhancement of patient life and controlled
blood pressure with greater persistence. Patients with ESRD face different types of problem
including their physical health and also affect their work, mental health and family activity.
Thus, it impacts on health-related quality of life and it is vital for health care providers in the
time of providing quality health care. Therefore, from the above discussion, it can be concluded
that home based-dialysis confers several advantages over institutional dialysis in the patient with
ESRD. However, more research is required to inspect the patient’s willingness to choose the
appropriate methods regarding enhancement of their healthy life. Well-designed systemic
approach and new interventions related to nursing practice, health professionals, new laboratory
measures must be formulated to improve the home dialysis treatment process (Jayanti, et al.,
2014).

9CRITICAL EVALUATION OF LITERATURE
References
Bonenkamp, A. A., van der Sluijs, A. V. E., Hoekstra, T., Verhaar, M. C., van Ittersum,
F. J., Abrahams, A. C., & van Jaarsveld, B. C. (2020). Health-Related Quality of Life
in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A
Systematic Review and Meta-analysis. Kidney Medicine.
Eneanya, N.D., Maddux, D.W., Reviriego-Mendoza, M.M. et al. Longitudinal patterns of
health-related quality of life and dialysis modality: a national cohort study. BMC
Nephrol 20, 7 (2019). https://doi.org/10.1186/s12882-018-1198-5
Fluck, R.J., Fouque, D. & Lockridge, R.S. Nephrologists’ perspectives on dialysis
treatment: results of an international survey. BMC Nephrol 15, 16 (2014).
https://doi.org/10.1186/1471-2369-15-16
Garg, A. X., Suri, R. S., Eggers, P., Finkelstein, F. O., Greene, T., Kimmel, P. L., ... &
Unruh, M. (2017). Patients receiving frequent hemodialysis have better health-related
quality of life compared to patients receiving conventional hemodialysis. Kidney
international, 91(3), 746-754.
Hajj, J. J., & Laudanski, K. (2017). Home Hemodialysis (HHD) Treatment as an effective
yet underutilized treatment modality in the United States. Healthcare 5(4), 90.
https://doi.org/10.3390/healthcare5040090
Ho Y-F, Li I-C. The influence of different dialysis modalities on the quality of life of
patients with end-stage renal disease: A systematic literature review. Psychology &

10CRITICAL EVALUATION OF LITERATURE
Health. 2016;31(12):1435. https://search.ebscohost.com/login.aspx?
direct=true&db=edb&AN=118525806&site=eds-live. Accessed February 11, 2020.
Ishani, A., Slinin, Y., Greer, N., MacDonald, R., Messana, J., Rutks, I., & Wilt, T. J.
(2015). Comparative effectiveness of home-based kidney dialysis versus in-center or
other outpatient kidney dialysis locations—a systematic review. Washington, DC,
Department of Veterans Affairs Health Services Research & Develoipment Service, 1-
153.
Jayanti, A., Morris, J., Stenvinkel, P., & Mitra, S. (2014). Home hemodialysis:
beliefs, attitudes, and practice patterns. Hemodialysis International, 18(4), 767-776.
Miller B, W, Himmele R, Sawin D, -A, Kim J, Kossmann R, J: Choosing Home
Hemodialysis: A Critical Review of Patient Outcomes. Blood Purif 2018;45:224-229.
doi: 10.1159/000485159
Palmer SC, Palmer AR, Craig JC, Johnson DW, Stroumza P, Frantzen L, Leal M,
Hoischen S, Hegbrant J, Strippoli GFM. Home versus in‐centre haemodialysis for
end‐stage kidney disease. Cochrane Database of Systematic Reviews 2014, Issue 11.
Art. No.: CD009535. DOI:
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009535.pub2/full
Rydell, H., Ivarsson, K., Almquist, M. et al. Improved long-term survival with home
hemodialysis compared with institutional hemodialysis and peritoneal dialysis: a
matched cohort study. BMC Nephrol 20, 52 (2019). https://doi.org/10.1186/s12882-
019-1245-x

11CRITICAL EVALUATION OF LITERATURE