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Representativeness of randomized clinical trial cohorts in end-stage kidney disease: A meta-analysis

JAMA Oct 17, 2019

Smyth B, Haber A, Trongtrakul K, et al. - Via a meta-analysis of 189 trials comprising 80,104 people, researchers ascertained whether individuals in huge, multicenter dialysis trials were comparable, in terms of age, comorbidities, and mortality rate, to the general population who were undergoing dialysis. In contrast with the 2011 US Renal Data System (USRDS) population, RCT members were younger, more inclined to be male, and have coronary artery disease and less prone to have diabetes or heart failure. During trial participation, the mortality rate per 100 patient-years was less than half of the USRDS population. When studies enrolling only from the United States were recognized, the variations in age, mortality, and coronary artery disease continued. Diabetes was more prevalent in RCT members from the United States vs the registry population. Thus, in comparison with the general population of patients who underwent dialysis, individuals in large, multicenter RCTs of people with end-stage kidney disease who underwent dialysis were younger, had a distinctive pattern of comorbidities along with a lower mortality rate. This finding has suggestions for the generalization of trial leads to the wider individual population and for the future trial plan.
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