Polyomavirus BK Replication in Adult Polycystic Kidney Disease Post–Renal Transplant Patients and Possible Role of Cellular Permissivity

Background: This study aimed to evaluate the hospitalization rates for subarachnoid hemorrhage (SAH) among renal transplant patients with adult polycystic kidney disease (ADPKD) and its outcomes, when compared to non-ADPKD renal transplant patients. Methods: The 2005–2014 National Inpatient Sample databases were used to identify all hospitalized renal transplant patients. The inpatient prevalence of SAH as a discharge diagnosis between ADPKD and non-ADPKD renal transplant patients was compared. Among SAH patients, the in-hospital mortality, use of aneurysm clipping, hospital length of stay, total hospitalization cost and charges between ADPKD and non-ADPKD patients were compared, adjusting for potential confounders. Results: The inpatient prevalence of SAH in ADPKD was 3.8/1000 admissions, compared to 0.9/1000 admissions in non-ADPKD patients (p < 0.01). Of 833 renal transplant patients with a diagnosis of SAH, 30 had ADPKD. Five (17%) ADPKD renal patients with SAH died in hospitals compared to 188 (23.4%) non-ADPKD renal patients (p = 0.70). In adjusted analysis, there was no statistically significant difference in mortality, use of aneurysm clipping, hospital length of stay, or total hospitalization costs and charges between ADPKD and non-ADPKD patients with SAH. Conclusion: Renal transplant patients with ADPKD had a 4-fold higher inpatient prevalence of SAH than those without ADPKD. Further studies are needed to compare the incidence of overall admissions in ADPKD and non-ADPKD patients. When renal transplant patients developed SAH, inpatient mortality rates were high regardless of ADPKD status. The outcomes, as well as resource utilization, were comparable between the two groups.

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The Role of Computed Tomography in the Evaluation of Adult Polycystic Kidney Disease

American Journal of Kidney Diseases ◽

10.1016/s0272-6386(81)80036-4 ◽

1981 ◽

Vol 1 (2) ◽

pp. 99-105 ◽

Cited By ~ 50

Author(s):

Errol Levine ◽

Jared J. Grantham

Keyword(s):

Computed Tomography ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Polycystic Kidney ◽

Adult Polycystic Kidney Disease

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The Role of Endothelial Dysfunction in Adult Polycystic Kidney Disease

Case Medical Research ◽

10.31525/ct1-nct04023214 ◽

2019 ◽

Author(s):

Keyword(s):

Endothelial Dysfunction ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Polycystic Kidney ◽

Adult Polycystic Kidney Disease

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Bilateral Nephrectomy for Adult Polycystic Kidney Disease Does Not Affect the Graft Function of Transplant Patients and Does Not Result in Sensitisation

BioMed Research International ◽

10.1155/2019/7423158 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Maria Irene Bellini ◽

Sotiris Charalmpidis ◽

Paul Brookes ◽

Peter Hill ◽

Frank J. M. F. Dor ◽

...

Keyword(s):

Kidney Disease ◽

Polycystic Kidney Disease ◽

Histopathological Examination ◽

Graft Function ◽

Length Of Hospital Stay ◽

Papillary Renal Cell Carcinoma ◽

Serum Levels ◽

Polycystic Kidney ◽

Adult Polycystic Kidney Disease ◽

Transplant Patients

Background. Native nephrectomy in Adult Polycystic Kidney Disease (ADPKD) patients is a major operation with controversy related to timing and indications. We present our single centre experience in transplanted patients and future candidates for transplantation. Methods. Retrospective analysis from an anonymised database of bilateral nephrectomies for ADPKD patients. Results were reported as median, range, and percentage. Differences between groups were tested using ANOVA and t-test. Surgery was performed between January 2012 and July 2018. Results. Thirty-three patients underwent bilateral native nephrectomy for APKD. 18 had a functioning kidney transplant (transplant group, 55%) while 15 patients were on dialysis (dialysis group, 45%) at the time of surgery; 8 patients of the latter group (24% of the whole cohort) were eventually transplanted. 53% were males, with median age of 55 years (27-71). Indications to surgery were the following: space (symptoms related to the size of the native kidneys or need to create space for transplantation) (59%), recurrent cyst infection (36%), haematuria (15%), pain (24%), and weight loss associated with cystic alteration on imaging (3%). In the transplant group, postoperative kidney function was not affected; haemoglobin serum levels significantly dropped in the whole cohort: 121 (82-150) g/L, versus 108 (58-154) g/L (p<0.001), with 14 patients being transfused perioperatively. Elevation of anti-HLA antibodies was noted in one female patient on dialysis, with no change in DSA levels and no rejection after transplant for all 26 transplanted patients. Median postoperative length of hospital stay was 9 days (6-71). One patient died (3%) after six months. Median follow-up for the whole cohort was 282 days (13-1834). Histopathological examination revealed incidental renal neoplasms in five cases (15%): 1 pT1a papillary renal cell carcinoma and 4 papillary adenomas. Conclusions. Native nephrectomy for ADPKD could be safely performed in case of refractory symptoms, suspect of cancer or to create space for transplantation. It does not affect graft function or DSA status of transplanted patients or the prospect of transplantation of those on the waiting list.

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