Background
There has been a long trajectory of concern regarding quality of life issues in the treatment of chronic kidney disease (CKD), beginning with the introduction of peritoneal dialysis, hemodialysis (HD) and renal transplantation (RT) in the early 1960s.  Renal replacement therapies have prolonged life and introduced significant life-style changes that impact quality of life.  

 Objectives
The purpose of this meta-analysis was to determine the magnitude of effect of RT on quality of life measures when compared with HD.

 Method
A systematic search of all renal replacement therapy studies was employed using computerized database searches, a review of reference lists, English journals, contact with experts, and no limitation on the year published.  calculated forThere were 16 studies that provided the necessary data for calculating effect sizes in standard deviation units

 Results
Specific domains for quality of life  included general overall quality of life as well as specific quality of life related to physical functioning and psychosocial functioning.  The summary effect size for general quality of life was 0.98.  The summary effect size for physical functioning was 0.77.  The summary effect size for psychosocial functioning was 0.39. 

 Discussion
Compared to HD, RT was significantly more effective in improving all three domains of quality of life, particularly general overall quality of life and physical functioning.  Psychosocial functioning was also better with RT, but less so than the other two domains.  There was a large range in these effect sizes across individual studies that could be explained by .... .  Studies are needed to address the effectiveness of RT on specific aspects of psychological and social functioning.