Peritoneal Dialysis can be an Option for Dominant Polycystic Kidney Disease: An Observational Study

BackgroundAutosomal dominant polycystic kidney disease (ADPKD) has been considered a relative contraindication for peritoneal dialysis (PD), although there are few specific studies available.MethodsA 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.ResultsPatients 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).ConclusionPeritoneal dialysis is a suitable renal replacement therapy option for ADPKD patients.

Download Full-text

Successful Peritoneal Dialysis After Renal Transcatheter Arterial Embolization in Autosomal Dominant Polycystic Kidney Disease

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2011.07.008 ◽

2011 ◽

Vol 58 (5) ◽

pp. 860-861 ◽

Cited By ~ 2

Author(s):

Takafumi Toyohara ◽

Noriko Hayami ◽

Yoshifumi Ubara

Keyword(s):

Peritoneal Dialysis ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Transcatheter Arterial Embolization ◽

Autosomal Dominant ◽

Arterial Embolization ◽

Polycystic Kidney ◽

Autosomal Dominant Polycystic Kidney

Download Full-text

Effect of Statins on Renal Function and Total Kidney Volume in Autosomal Dominant Polycystic Kidney Disease

Kidney Diseases ◽

10.1159/000509087 ◽

2020 ◽

Vol 6 (6) ◽

pp. 407-413

Author(s):

Cheng Xue ◽

Li-Ming Zhang ◽

Chenchen Zhou ◽

Chang-Lin Mei ◽

Sheng-Qiang Yu

Keyword(s):

Kidney Disease ◽

Polycystic Kidney Disease ◽

Autosomal Dominant ◽

Lipid Lowering ◽

Control Group ◽

Kidney Volume ◽

Polycystic Kidney ◽

Total Kidney Volume ◽

Yearly Change ◽

Autosomal Dominant Polycystic Kidney

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary nephropathy with few treatments to slow renal progression. The evidence on the effect of lipid-lowering agents (statins) on ADPKD progression remains inconclusive. Methods: We performed a systematic review and meta-analysis by searching the PubMed, Embase, Web of Science, and Cochrane databases (up to November 2019). Changes in estimated glomerular filtration rate (eGFR) and total kidney volume (TKV) were the primary outcomes. Mean differences (MDs) for continuous outcomes and 95% confidence intervals (CIs) were calculated by a random-effects model. Results: Five clinical studies with 648 participants were included. Statins did not show significant benefits in the yearly change in eGFR (4 studies, MD = −0.13 mL/min/m2, 95% CI: −0.78 to 0.52, p = 0.70) and the yearly change in TKV (3 studies, MD = −1.17%, 95% CI: −3.40 to 1.05, p = 0.30) compared with the control group. However, statins signiﬁcantly decreased urinary protein excretion (−0.10 g/day, 95% CI: −0.16 to -0.03, p = 0.004) and serum low-density lipoprotein level (−0.34 mmol/L, 95% CI: −0.58 to −0.10, p = 0.006). Conclusion: Despite these proteinuria and lipid-lowering benefits, the effect of statins on ADPKD progression was uncertain.

Download Full-text

A Case Report of Autosomal Dominant Polycystic Kidney Disease Under Peritoneal Dialysis With Cyst Infection and Culture-Positive Peritoneal Fluid

Clinical Medicine Insights Case Reports ◽

10.1177/1179547619846860 ◽

2019 ◽

Vol 12 ◽

pp. 117954761984686 ◽

Cited By ~ 1

Author(s):

Itaru Yasuda ◽

Kazuhiro Hasegawa ◽

Hirobumi Tokuyama ◽

Naoki Washida ◽

Keisuke Shinozuka ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Kidney Disease ◽

Blood Culture ◽

Polycystic Kidney Disease ◽

Peritoneal Fluid ◽

Autosomal Dominant ◽

Polymorphonuclear Leucocytes ◽

Polycystic Kidney ◽

Cyst Infection ◽

Autosomal Dominant Polycystic Kidney

Background: Cyst infection is a complication sometimes seen in patients with autosomal dominant polycystic kidney disease (ADPKD) and often shows through a positive blood culture. However, there have been no reports of ADPKD patients whose cyst infection propagate to peritoneal fluid leading to positive peritoneal fluid culture. Case presentation: A 74-year-old Japanese man with ADPKD under peritoneal dialysis (PD) was presented with left flank pain, fever, and chills at our hospital. He did not show any symptoms or signs suggestive of peritonitis. There were no elevated cell counts or polymorphonuclear leucocytes in his PD fluid. There were some complicated cysts found in computed tomography and magnetic resonance imaging examinations. We clinically diagnosed him as having a renal cyst infection rather than PD-related peritonitis. We initiated treatment by administering ceftriaxone with an immediate favorable response. As the possibility of accompanying prostatitis still remained, we switched to intravenous levofloxacin on the second day. On the 10th day, Helicobacter cinaedi was detected in 2 sets of blood culture as well as in PD fluid. We switched back to ceftriaxone and this treatment was entirely successful. Conclusions: This is the first report of H cinaedi cyst infection which propagates to peritoneal fluid in a patient with ADPKD.

Download Full-text

Peritoneal Dialysis for Patients with Autosomal Dominant Polycystic Kidney Disease

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00273 ◽

2017 ◽

Vol 37 (4) ◽

pp. 384-388 ◽

Cited By ~ 6

Author(s):

Sana Khan ◽

Anna Giuliani ◽

Carlo Crepaldi ◽

Claudio Ronco ◽

Mitchell H. Rosner

Keyword(s):

Peritoneal Dialysis ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Autosomal Dominant ◽

Disease Patient ◽

Cystic Kidney ◽

Polycystic Kidney ◽

Autosomal Dominant Polycystic Kidney ◽

Stage Renal Disease ◽

End Stage

End-stage renal disease secondary to autosomal dominant poly-cystic kidney (ADPKD) is a common issue worldwide. Peritoneal dialysis (PD) is a reasonable option for renal replacement therapy for these patients and should not be withheld due to concerns that the patient may not tolerate the fluid volumes in the peritoneal cavity. This review covers the existing data on the outcomes and complications associated with the use of PD in the polycystic kidney disease patient. In general, PD is well tolerated and outcomes in ADPKD patients are equivalent to or better than other patient groups.

Download Full-text