Koc Yener, Basturk Taner, Sakaci Tamer, Atan Ucar Zuhal, Ahbap Elbis, Sevinc Mustafa, Sinangil Ayse, Kara Ekrem, Ozdemir Kayalar Arzu, Bayraktar Caglayan Feyza, Sahutoglu Tuncay, Baris Hasbal Nuri, Ünsal Abdulkadir
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Nephrol Ther. 2016 Jul;12(4):215-20. doi: 10.1016/j.nephro.2015.12.006. Epub 2016 Jun 16.
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.
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.
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).
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.
由于多囊肾病（PKD）患者腹腔空间有限，并发症风险增加且技术失败风险升高，常不采用腹膜透析（PD）治疗。在本研究中，我们旨在确定接受PD治疗的PKD患者的临床结局、患者生存率和技术生存率，并确定PD是否适合这些患者。
本回顾性研究共纳入99例患者，其中33例为PKD患者，66例为PKD以外疾病的患者。所有患者均在2001年至2015年期间开始PD治疗，并根据PD治疗开始时间进行匹配。评估了特定时期内的社会人口学特征、临床数据和并发症。对所有患者调查了与死亡率、患者生存率和技术生存率相关的因素。
两组在人口统计学、基线和末次随访时的临床及实验室参数、其他全身性疾病方面相似，但PKD患者的治疗前和末次随访时血清白蛋白水平较高（分别为P=0.03和0.01），非PKD患者年龄较小（P=0.002）。两组腹膜炎和导管出口处/隧道感染的发生率相似（分别为P=0.26和0.12）。两组在渗漏和疝的发生方面相似（分别为P=0.07和0.57）。到研究期结束时，PKD组有10例患者转为血液透析（HD）并接受了肾移植，仅6例患者死亡。非PKD组有19例患者转为HD，11例患者接受了肾移植，23例患者死亡。PKD组死亡率较低（对数秩检验=0.034）。两组在死亡和转为HD的原因方面相似（分别为P=0.35和0.36）。两组的技术生存率相似（对数秩检验=0.37）。
腹膜透析可能是PKD患者合适的肾脏替代治疗选择。PKD不是接受PD治疗患者的额外危险因素。死亡率与非糖尿病PD患者相似。PKD患者腹膜透析的总体技术生存率、疝、渗漏和感染并发症发生率与非PKD患者相似。
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