title: Peritoneal Dialysis Can Be an Option for Dominant Polycystic Kidney Disease: an Observational Study.
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).
  
  
  CONCLUSIONS
  Peritoneal dialysis is a suitable renal replacement therapy option for ADPKD patients.
authors.affiliation: Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
authors.forename: Darío
authors.initials: D
authors.lastname: Janeiro
authors.affiliation: Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain josem.portoles@salud.madrid.org.
authors.forename: Jose
authors.initials: J
authors.lastname: Portolés
authors.affiliation: Nephrology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Tato
authors.affiliation: Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: López-Sánchez
authors.affiliation: Nephrology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Del Peso
authors.affiliation: Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Rivera
authors.affiliation: Nephrology, Hospital San Pedro de Alcántara, Cáceres, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Castellano
authors.affiliation: Nephrology, Hospital General de Segovia, Segovia, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Fernández-Reyes
authors.affiliation: Nephrology, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pérez-Gómez
authors.affiliation: Nephrology, Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Mayra
authors.initials: M
authors.lastname: Ortega
authors.affiliation: Nephrology, Hospital Príncipe de Asturias, Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez-Miguel
authors.affiliation: Nephrology, Hospital Nuestra Señora de Sonsoles, Ávila, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Felipe
authors.affiliation: Nephrology, H. G. Ciudad Real, Ciudad Real, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Caparrós
authors.affiliation: Nephrology, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.affiliation: Nephrology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis; D016891:Polycystic Kidney, Autosomal Dominant / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Peritoneal dialysis outcomes; abdominal wall complications; comorbidity; dialysis modality; kidney transplant; mortality; peritonitis; technique failure