Darío Janeiro1, Jose Portolés2, Ana María Tato3, Paula López-Sánchez1, Gloria Del Peso4, Maite Rivera5, Inés Castellano6, Maria J Fernández-Reyes7, Vanessa Pérez-Gómez8, Mayra Ortega9, Patricia Martínez-Miguel10, Carmen Felipe11, Guadalupe Caparrós12, Alberto Ortiz8, Rafael Selgas4. 1. Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain. 2. Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain josem.portoles@salud.madrid.org. 3. Nephrology, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 4. Nephrology, Hospital Universitario La Paz, Madrid, Spain. 5. Nephrology, Hospital Ramón y Cajal, Madrid, Spain. 6. Nephrology, Hospital San Pedro de Alcántara, Cáceres, Spain. 7. Nephrology, Hospital General de Segovia, Segovia, Spain. 8. Nephrology, Fundación Jiménez Díaz, Madrid, Spain. 9. Nephrology, Hospital Infanta Leonor, Madrid, Spain. 10. Nephrology, Hospital Príncipe de Asturias, Madrid, Spain. 11. Nephrology, Hospital Nuestra Señora de Sonsoles, Ávila, Spain. 12. Nephrology, H. G. Ciudad Real, Ciudad Real, Spain.
Abstract
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) has been considered a relative contraindication for peritoneal dialysis (PD), although there are few specific studies available. METHODS: A multicenter historical prospective matched-cohort study was conducted to describe the outcome of ADPKD patients who have chosen PD. All ADPKD patients starting PD (n = 106) between January 2003 and December 2010 and a control group (2 consecutive patients without ADPKD) were studied. Mortality, PD-technique failure, peritonitis, abdominal wall leaks and cyst infections were compared. RESULTS: Patients with ADPKD had similar age but less comorbidity at PD inclusion: Charlson comorbidity index (CCI) 4.3 (standard deviation [SD] 1.6) vs 5.3 (SD 2.5) p < 0.001, diabetes mellitus 5.7% vs 29.2%, p < 0.001 and previous cardiovascular events 10.4% vs 27.8%, p < 0.001. No differences were observed in clinical events that required transient transfer to hemodialysis, nor in peritoneal leakage episodes or delivered dialysis dose. The cyst infection rate was low (0.09 episodes per patient-year) and cyst infections were not associated to peritonitis episodes. Overall technique survival was similar in both groups. Permanent transfer to hemodialysis because of surgery or peritoneal leakage was more frequent in ADPKD. More ADPKD patients were included in the transplant waiting list (69.8 vs 58%, p = 0.04) but mean time to transplantation was similar (2.08 [1.69 - 2.47] years). The mortality rate was lower (2.5 vs 7.6 deaths/100 patient-year, p = 0.02) and the median patient survival was longer in ADPKD patients (6.04 [5.39 - 6.69] vs 5.57 [4.95 - 6.18] years, p = 0.024). CONCLUSION: Peritoneal dialysis is a suitable renal replacement therapy option for ADPKD patients.
BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) has been considered a relative contraindication for peritoneal dialysis (PD), although there are few specific studies available. METHODS: A multicenter historical prospective matched-cohort study was conducted to describe the outcome of ADPKDpatients who have chosen PD. All ADPKDpatients starting PD (n = 106) between January 2003 and December 2010 and a control group (2 consecutive patients without ADPKD) were studied. Mortality, PD-technique failure, peritonitis, abdominal wall leaks and cyst infections were compared. RESULTS:Patients with ADPKD had similar age but less comorbidity at PD inclusion: Charlson comorbidity index (CCI) 4.3 (standard deviation [SD] 1.6) vs 5.3 (SD 2.5) p < 0.001, diabetes mellitus 5.7% vs 29.2%, p < 0.001 and previous cardiovascular events 10.4% vs 27.8%, p < 0.001. No differences were observed in clinical events that required transient transfer to hemodialysis, nor in peritoneal leakage episodes or delivered dialysis dose. The cyst infection rate was low (0.09 episodes per patient-year) and cyst infections were not associated to peritonitis episodes. Overall technique survival was similar in both groups. Permanent transfer to hemodialysis because of surgery or peritoneal leakage was more frequent in ADPKD. More ADPKDpatients were included in the transplant waiting list (69.8 vs 58%, p = 0.04) but mean time to transplantation was similar (2.08 [1.69 - 2.47] years). The mortality rate was lower (2.5 vs 7.6 deaths/100 patient-year, p = 0.02) and the median patient survival was longer in ADPKDpatients (6.04 [5.39 - 6.69] vs 5.57 [4.95 - 6.18] years, p = 0.024). CONCLUSION: Peritoneal dialysis is a suitable renal replacement therapy option for ADPKDpatients.
Authors: W F Keane; G R Bailie; E Boeschoten; R Gokal; T A Golper; C J Holmes; Y Kawaguchi; B Piraino; M Riella; S Vas Journal: Perit Dial Int Date: 2000 Jul-Aug Impact factor: 1.756
Authors: Bénédicte Stengel; Solenne Billon; Paul C W Van Dijk; Kitty J Jager; Friedo W Dekker; Keith Simpson; J Douglas Briggs Journal: Nephrol Dial Transplant Date: 2003-09 Impact factor: 5.992
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Authors: Magdalena Jankowska; Michał Chmielewski; Monika Lichodziejewska-Niemierko; Piotr Jagodziński; Bolesław Rutkowski Journal: Int Urol Nephrol Date: 2015-08-19 Impact factor: 2.370