Mickael Sigogne1, Lukshe Kanagaratnam2, Vincent Dupont1, Cécile Couchoud3, Christian Verger4, Hervé Maheut1, Marc Hazzan5, Jean Michel Halimi6, Coralie Barbe2, Eric Canivet1, Andréea Petrache1, Moustapha Dramé2, Philippe Rieu1,7, Fatouma Touré1,7. 1. Division of Nephrology, University Hospital of Reims, Reims, France. 2. Clinical Investigation Center, University Hospital of Reims, Reims, France. 3. REIN: the French Renal Epidemiology and Information Network Registry (Agence de la biomedecine Paris). 4. RDPLF: the French Language Peritoneal Dialysis Registry, Pontoise, France. 5. Division of Nephrology-University Hospital of Lille and UMR 995, Lille, France. 6. Division of Nephrology and Immunology University Hospital of Tours, Tours, France. 7. Laboratory of Nephrology, UMR CNRS URCA 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC).
Abstract
Background: Pathological features of autosomal dominant polycystic kidney disease (ADPKD) include enlarged kidney volume, higher frequency of digestive diverticulitis and abdominal wall hernias. Therefore, many nephrologists have concerns about the use of peritoneal dialysis (PD) in ADPKD patients. We aimed to analyse survival and technique failure in ADPKD patients treated with PD. Methods: We conducted two retrospective studies on patients starting dialysis between 2000 and 2010. We used two French registries: the French Renal Epidemiology and Information Network (REIN) and the French language Peritoneal Dialysis Registry (RDPLF). Using the REIN registry, we compared the clinical features and outcomes of ADPKD patients on PD (n = 638) with those of ADPKD patients on haemodialysis (HD) (n = 4653); with the RDPLF registry, those same parameters were determined for ADPKD patients on PD (n = 797) and compared with those of non-ADPKD patients on PD (n = 12 059). Results: A total of 5291 ADPKD patients and 12 059 non-ADPKD patients were included. Analysis of the REIN registry found that ADPKD patients treated with PD represented 10.91% of the ADPKD population. During the study period, PD was used for 11.2% of the non-ADPKD population. Compared with ADPKD patients on HD, ADPKD patients on PD had higher serum albumin levels (38.8 ± 5.3 versus 36.8 ± 5.7 g/dL, P < 0.0001) and were less frequently diabetic (5.31 versus 7.71%, P < 0.03). The use of PD in ADPKD patients was positively associated with the occurrence of a kidney transplantation but not with death [hazard ratio 1.15 (95% confidence interval 0.84-1.58)]. Analysis of the RDPLF registry found that compared with non-ADPKD patients on PD, ADPKD patients on PD were younger and had fewer comorbidities and better survival. ADPKD status was not associated with an increased risk of technique failure or an increased risk of peritonitis. Conclusions: According to our results, PD is proposed to a selected population of ADPKD patients, PD does not have a negative impact on ADPKD patients' overall survival and PD technique failure is not influenced by ADPKD status. Therefore PD is a reasonable option for ADPKD patients.
Background: Pathological features of autosomal dominant polycystic kidney disease (ADPKD) include enlarged kidney volume, higher frequency of digestive diverticulitis and abdominal wall hernias. Therefore, many nephrologists have concerns about the use of peritoneal dialysis (PD) in ADPKDpatients. We aimed to analyse survival and technique failure in ADPKDpatients treated with PD. Methods: We conducted two retrospective studies on patients starting dialysis between 2000 and 2010. We used two French registries: the French Renal Epidemiology and Information Network (REIN) and the French language Peritoneal Dialysis Registry (RDPLF). Using the REIN registry, we compared the clinical features and outcomes of ADPKDpatients on PD (n = 638) with those of ADPKDpatients on haemodialysis (HD) (n = 4653); with the RDPLF registry, those same parameters were determined for ADPKDpatients on PD (n = 797) and compared with those of non-ADPKDpatients on PD (n = 12 059). Results: A total of 5291 ADPKDpatients and 12 059 non-ADPKDpatients were included. Analysis of the REIN registry found that ADPKDpatients treated with PD represented 10.91% of the ADPKD population. During the study period, PD was used for 11.2% of the non-ADPKD population. Compared with ADPKDpatients on HD, ADPKDpatients on PD had higher serum albumin levels (38.8 ± 5.3 versus 36.8 ± 5.7 g/dL, P < 0.0001) and were less frequently diabetic (5.31 versus 7.71%, P < 0.03). The use of PD in ADPKDpatients was positively associated with the occurrence of a kidney transplantation but not with death [hazard ratio 1.15 (95% confidence interval 0.84-1.58)]. Analysis of the RDPLF registry found that compared with non-ADPKDpatients on PD, ADPKDpatients on PD were younger and had fewer comorbidities and better survival. ADPKD status was not associated with an increased risk of technique failure or an increased risk of peritonitis. Conclusions: According to our results, PD is proposed to a selected population of ADPKDpatients, PD does not have a negative impact on ADPKDpatients' overall survival and PD technique failure is not influenced by ADPKD status. Therefore PD is a reasonable option for ADPKDpatients.