title: Peritoneal dialysis as the first-line renal replacement therapy in patients with autosomal dominant polycystic kidney disease.
abstract: BACKGROUND
  Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of kidney failure. Peritoneal dialysis (PD) often is avoided because of concerns about hernias and peritonitis.
  
  
  METHODS
  Retrospective matched-cohort study.
  
  
  METHODS
  42 consecutive patients with ADPKD and 84 nondiabetic patients matched by time of PD therapy initiation.
  
  
  METHODS
  ADPKD and comorbid conditions.
  
  
  RESULTS
  Patient survival, technique survival, peritonitis-free survival; peritonitis rate; abdominal hernias.
  
  
  METHODS
  Dialysis adequacy and nutritional indexes; rate of decrease in residual renal function; bacteriologic cause of peritonitis.
  
  
  RESULTS
  5-year actuarial survival of the ADPKD and control groups was 71.0% and 69.7% (P = 0.4), whereas technique survival was 51.6% and 37.3%, respectively (P = 0.2). There was no difference in overall rates of peritonitis between the ADPKD and control groups (0.51 vs 0.53 episodes/patient-year; P = 0.3), and the incidence of Gram-negative peritonitis also was similar (0.16 vs 0.14 episodes/patient year; P = 0.5). Abdominal wall hernia was significantly more common in the ADPKD than control group (14 vs 6 cases; P < 0.001), but all patients were able to resume PD therapy after surgical repair.
  
  
  CONCLUSIONS
  Retrospective study with limited sample size.
  
  
  CONCLUSIONS
  PD is a feasible treatment option for most patients with ADPKD with end-stage renal disease. Although patients with ADPKD have a higher risk of abdominal wall hernia, their overall survival rate and risk of peritonitis are similar to those of other nondiabetic PD patients.
authors: Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China. lilin_616@163.com
authors: Lin
authors: L
authors: Li
authors: Cheuk-Chun
authors: CC
authors: Szeto
authors: Bonnie Ching-Ha
authors: BC
authors: Kwan
authors: Kai-Ming
authors: KM
authors: Chow
authors: Chi-Bon
authors: CB
authors: Leung
authors: Philip
authors: P
authors: Kam-Tao Li
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D016891:Polycystic Kidney, Autosomal Dominant / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome