Mendelssohn D C, Harding M E, Cardella C J, Cook G T, Uldall P R
Toronto Hospital, Ontario, Canada.
Clin Nephrol. 1988 Dec;30(6):315-9.
This is an analysis of the outcome of 35 patients with end-stage autosomal dominant polycystic kidney disease (ADPKD) at Toronto Western Hospital (TWH) during a 10-year period. The primary treatment in each case was hemodialysis. In the 15 patients managed exclusively with hemodialysis the one- and five-year actuarial survival was 93% and 77% respectively. Twenty patients ultimately received a total of 26 cadaveric renal allografts. Graft survival at one year was 76%. One- and five-year patient survival was 92% and 73% respectively. Beyond 5 years a trend towards increased survival in the transplant group was seen, compared with the exclusively hemodialyzed group. Bilateral nephrectomy prior to transplantation was associated with high morbidity and mortality, and did not change either graft or patient survival. In view of the similar survival and because it is accepted that transplantation offers the highest quality of life amongst the modalities of treatment for end-stage renal failure, transplantation should be considered the treatment of choice for end-stage ADPKD. There is no justification for routine bilateral nephrectomy before renal transplantation.
这是一项对多伦多西区医院（TWH）10年间35例终末期常染色体显性多囊肾病（ADPKD）患者治疗结果的分析。每例患者的主要治疗方法是血液透析。在仅接受血液透析治疗的15例患者中，1年和5年精算生存率分别为93%和77%。20例患者最终共接受了26次尸体肾移植。移植肾1年生存率为76%。患者1年和5年生存率分别为92%和73%。与仅接受血液透析的组相比，5年后移植组出现了生存率增加的趋势。移植前双侧肾切除术与高发病率和死亡率相关，且并未改变移植肾或患者的生存率。鉴于生存率相似，并且公认在终末期肾衰竭的各种治疗方式中，移植能提供最高的生活质量，因此移植应被视为终末期ADPKD的首选治疗方法。肾移植前进行常规双侧肾切除术没有依据。
