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Kidney Week

Abstract: FR-PO508

Is Peritoneal Dialysis a Good Technique for Patients with Autosomal Dominant Polycystic Kidney Disease?

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Useche Bonilla, Gustavo Andres, Hospital General Universitario de Valencia, Valencia, Spain
  • Vilar, Ana, Hospital General Universitario de Valencia, Valencia, Spain
  • Aparicio, Sara, Hospital General Universitario de Valencia, Valencia, Spain
  • Palacios castillo, Ángel, Hospital General Universitario de Valencia, Valencia, Spain
  • Gimenez Edo, Margarita, Hospital General Universitario de Valencia, Valencia, Spain
  • Galan Serrano, Antonio, Hospital General Universitario de Valencia, Valencia, Spain
Background

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most frequent genetic cause of Chronic Kidney Disease, progressing in most cases to End-Stage Renal Disease. Initially, Peritoneal Dialysis (PD) was contraindicated in this kind of patients, because it was thought that an already elevated abdominal volume would decrease the tolerance and promote a higher incidence of complications. However, this trend is in reverse and every day there are more patients with ADPKD in PD without showing more complications, with good tolerability and adequacy.

Methods

Descriptive, retrospective, unicentric study design; we selected all the patients with a diagnosis of ADPKD and that entered our PD program between April 1st, 1999 and March 31st, 2018. Every one of these patients was matched with 2 non-ADPKD patient who also entered our PD program in the same time period.
We proceed to compare the incidence of dialysate leaks, eventrations, peritonitis; the number of hospitalizations and technique failures, and the PD adequacy in both groups through their Kt/V and nPCR at 6, 12, 18 and 24 months of beginning the technique.

Results

Comparing the basal characteristics of both groups, there was only significant difference in the Charlson index score. The ADPKD group had a mean of 2.9 ±1.07, while the non-ADPKD group had 4.2 ± 1.97.
The most common cause to enter on PD program was patient choice. The mean technique survival was similar in both groups 969.6 ± 667.4 vs 847.5 ± 666.4 days. The proportion of patients in APD was higher in the ADPKD group, 71 vs 46% (p = 0.1).
The means of episodes of peritonitis, dialysate leaks and hospitalizations were similar. The most common cause of withdrawal from the program was transplant (50 vs 32%); the percentage of infradialysis was higher in the non-ADPKD group (7 vs 18%).
Kt/V mean was > 1.7 in both groups, but it was overall lower in the ADPKD group. A value of p < 0.0.5 was only achieved when the peritoneal Kt/V was contrasted.

Conclusion

ADPKD patients not show higher risk of PD complications or technique failure when compared with non-ADPKD with similar characteristics. PD is an effective treatment modality for ADPKD patients, and ADPKD should not be taken as an absolute contraindication. PD adequacy thresholds are achievable in ADPKD patients.