Is peritoneal dialysis a therapeutic option for polycystic kidney disease? 15 years' experience in a single center.
BACKGROUND
Peritoneal dialysis (PD) is often avoided for patients with polycystic kidney disease (PKD) because of increased risk of complications and technique failure due to limited intra-abdominal space. In this study, we have aimed to determine clinical outcomes, patient and technique survivals in patients with PKD performing PD and to define whether PD is appropriate for these patients.


METHODS
Totally 99 patients: 33 with PKD and 66 with diseases other than PKD were included in this retrospective study. All patients started PD between 2001 and 2015 years and have been matched by time of PD therapy initiation. Socio-demographic characteristics, clinical data and complications during the specified period were evaluated. The factors associated with mortality and patient and technique survival were investigated for all patients.


RESULTS
The two groups were similar in terms of demographic, baseline and last visit clinical and laboratory parameters, additional systemic diseases, with the exception of higher pretreatment and last visit serum albumin levels in PKD patients (P=0.03 and 0.01 respectively) and younger age of non-PKD patients (P=0.002). Incidence of peritonitis and catheter exit-site/tunnel infections were similar among the two groups (P=0.26 and 0.12 respectively). The two groups were similar in terms of leak and hernia developments (P=0.07 and 0.57, respectively). By the end of the study period; in PKD group, 10 patients had been transferred to HD and had kidney transplantation and only 6 patients had died. In non-PKD group, 19 patients had been transferred to HD, 11 patients had kidney transplantation and 23 patients had died. Mortality was lower in PKD group (log rank=0.034). The two groups were similar regarding death and HD transfer reasons (P=0.35 and 0.36 respectively). The technique survival rates were similar among the two groups (log rank=0.37).


CONCLUSIONS
Peritoneal dialysis may be a suitable renal replacement therapy option for PKD patients. PKD is not an additional risk factor in patients treated by PD. Mortality is similar with non-diabetic PD patients. Peritoneal dialysis in PKD patients is associated with a similar overall rate of technique survival, incidences of hernia, leak and infectious complications as in non-PKD patients.
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey. Electronic address: dryenerkoc@mynet.com.
Yener
Y
Koc
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Taner
T
Basturk
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Tamer
T
Sakaci
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Zuhal
Z
Atan Ucar
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Elbis
E
Ahbap
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Mustafa
M
Sevinc
Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey.
Ayse
A
Sinangil
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Ekrem
E
Kara
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Arzu
A
Ozdemir Kayalar
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Feyza
F
Bayraktar Caglayan
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Tuncay
T
Sahutoglu
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Nuri
N
Baris Hasbal
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Abdulkadir
A
Ünsal
D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010530:Peritoneal Dialysis; D007690:Polycystic Kidney Diseases / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D014421:Turkey
Mortality; Peritoneal dialysis; Polycystic kidney disease