Is peritoneal dialysis a therapeutic option for polycystic kidney disease? 15 years' experience in a single center

Abstract

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. (C) 2016 Association Societe de nephrologie. Published by Elsevier Masson SAS. All rights reserved.