Abstract: FR-OR080
Peritoneal Dialysis in ADPKD
Session Information
- What's New at Home (Dialysis)?
November 07, 2025 | Location: Room 351D, Convention Center
Abstract Time: 05:40 PM - 05:50 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Gunning, Samantha, The University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- McGill, Rita L., The University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Chapman, Arlene B., The University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Garimella, Pranav S., University of California San Diego, La Jolla, California, United States
Background
Peritoneal dialysis (PD) is a convenient, home-based form of dialysis. Patients with autosomal dominant polycystic kidney disease (ADPKD) are often optimal PD candidates with good family support, health literacy, and few comorbid conditions. However, clinicians may hesitate to choose PD for ADPKD patients given their organomegaly, possible increased intraabdominal pressure, and concerns for complications and ability to tolerate PD. Little is known about clinical outcomes of ADPKD patients undergoing PD.
Methods
We analyzed a retrospective cohort of all patients ≥30 years old with cystic kidney disease in the US Renal Data System up to 12/2021, followed till death or 1/2023. A time-dependent variable for modality [PD, hemodialysis (HD), transplant (Tx)] was created. HD exposure was the reference category, enabling hazard ratios based on days exposed to PD and proximity to outcome events (death and Tx). Cox models were adjusted for age, sex, race, BMI, albumin, albumin, hemoglobin, time period, and comorbid conditions at inclusion, with multiple imputation of missing data.
Results
There were 84,053 ADPKD patients in the analytical dataset. Mean age was 56±12 years; 47% were female. Median follow-up was 82 (IQR: 37-154) months. PD exposure occurred in 27% of ADPKD patients, compared to 29% of non-ADPKD patients during the study period. ADPKD patients were more likely to have PD exposure if they were female, younger, and had fewer comorbid conditions. PD was inititated within the first year for 86% of PD-exposed ADPKD patients. Median PD exposure in ADPKD was 20 (IQR: 8,39) months. Ten-year treatment outcomes are shown (figure). Compared to HD, PD exposure was not associated with increased mortality (HR: 1.03, 95%CI=0.99-1.06, P=0.13) and had a higher likelihood of Tx (HR: 1.11 (95%CI=1.07-1.14, P<0.001).
Conclusion
Retrospective national data from the US indicate that PD is a viable dialysis option for ADPKD patients, without compromising survival or opportunities for kidney Tx.