OBJECTIVES: This study was conducted with the purpose of search evidence in terms of the efficacy and safety that to demonstrated advantages of any of the renal replacement therapy in terms of peritoneal dialysis (PD), hemodialysis (HD) and kidney transplant (KT) , used in patients with chronic kidney failure.

METHODS: The systematic review was performed BY Cochrane Methodology in PubMed/Medline, Cochrane Library, and LILAC’s. Only observational studies were included in adult patients with chronical kidney failure and that were under one of the renal replacements treatments were included. STROBE tool was used to evaluate the quality of these studies.

RESULTS: Of the 4,472 studies, only 8 observational studies fulfil the inclusion criteria. From these only 6 studies compared peritoneal dialysis vs haemodialysis, from which , it was proven that patients with PD show better comorbidities in comparison with those who are under treatment with haemodialysis (diabetes, cardiovascular and cardiac diseases One additionally study evaluates the quality of life in all substitution therapies , where it was reported that patients who received KT showed a bigger satisfaction with the therapy (4.85) in comparison with PD (3.59) and HD (4.59). On the other hand, the las study evaluates the survival during 18 months between those three treatments, being better in KT (96.9±0.031) vs DP (94±0.024) vs HD (83±0.093). Population consist of: 66,190 patients that were distributed in PD 21,163, HD 44,904 and KT 123. Evaluated in average of 61 months for HD and 50 months for PD.

CONCLUSIONS: While evaluating only observational studies, these demonstrate that KT could be the election therapy in patients with chronic kidney disease, However, more evidence is necessary and with higher quality level in order to sustain the research.