Document Detail

Peritoneal dialysis as the first-line renal replacement therapy in patients with autosomal dominant polycystic kidney disease.
MedLine Citation:
PMID:  21458901     Owner:  NLM     Status:  MEDLINE    
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.
STUDY DESIGN: Retrospective matched-cohort study.
SETTING & PARTICIPANTS: 42 consecutive patients with ADPKD and 84 nondiabetic patients matched by time of PD therapy initiation.
PREDICTORS: ADPKD and comorbid conditions.
OUTCOMES: Patient survival, technique survival, peritonitis-free survival; peritonitis rate; abdominal hernias.
MEASUREMENTS: 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.
LIMITATIONS: Retrospective study with limited sample size.
CONCLUSION: 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.
Lin Li; Cheuk-Chun Szeto; Bonnie Ching-Ha Kwan; Kai-Ming Chow; Chi-Bon Leung; Philip Kam-Tao Li
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-02
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  57     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-07-21     Revised Date:  2011-09-30    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  903-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
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MeSH Terms
Middle Aged
Peritoneal Dialysis*
Polycystic Kidney, Autosomal Dominant / mortality,  physiopathology,  therapy*
Renal Replacement Therapy
Retrospective Studies
Survival Rate / trends
Treatment Outcome
Comment In:
Am J Kidney Dis. 2011 Sep;58(3):493-4; author reply 494   [PMID:  21856496 ]
Am J Kidney Dis. 2011 Sep;58(3):493; author reply 494   [PMID:  21856497 ]

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