Swai J, Zhao X, Noube JR, et al. - This study was sought to correlate the risks of lupus flares, all-cause infections, all-cause cardiovascular events, and mortality, between hemodialysis versus peritoneal dialysis as initial renal replacement therapies (RRT) - modality before renal-transplant in lupus nephritis end-stage renal disease (LN-ESRD) patients, by systematic review and meta-analysis. Researchers carried out to search PubMed, EMBASE, and SCOPUS for observational-studies comparing LN-ESRD -patients undergoing hemodialysis (Group1) vs peritoneal-dialysis (Group 2) prior to renal-transplantation, by their risks of lupus flare, all-cause infections, all-cause cardiovascular events, and mortality as outcome measures. They applied RevMan 5.3 computer software for analysis. Research included 16 eligible studies including 15,636 LN-ESRD -patients prior to renal transplantation with 4,616 patients on hemodialysis, 2089 on peritoneal dialysis, 280 directly underwent kidney transplantation, 8319 were eliminated with reasons and 332 participants’ details were not reported. The data indicated that both treatment modalities offer more or less similar clinical outcomes as effective initial choices of RRT in LN-ESRD patients prior to renal transplant, except for all-cause cardiovascular events in which peritoneal dialysis is superior to hemodialysis offering better outcomes.