Suwabe Tatsuya, Ubara Yoshifumi, Oba Yuki, Mizuno Hiroki, Ikuma Daisuke, Yamanouchi Masayuki, Sekine Akinari, Tanaka Kiho, Hasegawa Eiko, Hoshino Junichi, Sawa Naoki
Department of Nephrology, Toranomon Hospital, Tokyo and Kawasaki, Japan.
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
Mayo Clin Proc Innov Qual Outcomes. 2023 Jan 20;7(1):69-80. doi: 10.1016/j.mayocpiqo.2022.12.005. eCollection 2023 Feb.
To examine the changes in total kidney volume (TKV) and total liver volume (TLV) before and after dialysis initiation in patients with autosomal dominant polycystic kidney disease.
This was a retrospective, single-center cohort study to investigate the changes in TKV and TLV before and after dialysis initiation, along with influencing factors, using linear mixed models. We enrolled 95 patients with autosomal dominant polycystic kidney disease (85 receiving hemodialysis [HD] and 10 receiving peritoneal dialysis [PD]) who began receiving dialysis at Toranomon Hospital from January 1, 2008, to December 31, 2020.
The least squares mean TKV ratio (TKV at each time point/TKV at dialysis initiation) was 63.8% (95% confidence interval [CI], 54.7%-72.9%) at 6 years before dialysis initiation and 95.5% (95% CI, 82.9%-108.2%) at 6 years after dialysis initiation (<.001). A multivariate linear mixed model analysis revealed that dialysis style (HD or PD) had the strongest effect on changes in TKV (=.002). The least squares mean TLV ratio was 98.2% (95% CI, 88.4%-108.0%) at 6 years before dialysis initiation and 95.7% (95% CI, 85.2%-106.2%) at 6 years after dialysis initiation (=.01). Although PD did not have significant effects on changes in TLV (=.27), the changes in TLV were greater in patients on PD than in those on HD.
The TKV increased until dialysis initiation and generally decreased after dialysis initiation. The TLV continued to increase even after dialysis initiation, however, changes in the TLV significantly decreased after dialysis initiation. The increases in TKV and TLV were greater in patients on PD than in those on HD.
研究常染色体显性遗传性多囊肾病患者开始透析前后的总肾体积（TKV）和总肝体积（TLV）变化。
这是一项回顾性单中心队列研究，采用线性混合模型调查开始透析前后TKV和TLV的变化及其影响因素。我们纳入了95例常染色体显性遗传性多囊肾病患者（85例接受血液透析[HD]，10例接受腹膜透析[PD]），这些患者于2008年1月1日至2020年12月31日在东京新桥医院开始接受透析治疗。
透析开始前6年，TKV比值（各时间点的TKV/透析开始时的TKV）的最小二乘均值为63.8%（95%置信区间[CI]，54.7%-72.9%），透析开始后6年为95.5%（95%CI，82.9%-108.2%）（P<0.001）。多变量线性混合模型分析显示，透析方式（HD或PD）对TKV变化的影响最大（P=0.002）。透析开始前6年，TLV比值的最小二乘均值为98.2%（95%CI，88.4%-108.0%），透析开始后6年为95.7%（95%CI，85.2%-106.2%）（P=0.01）。虽然PD对TLV变化无显著影响（P=0.27），但接受PD治疗的患者TLV变化大于接受HD治疗的患者。
TKV在透析开始前增加，透析开始后总体下降。TLV在透析开始后仍继续增加，不过透析开始后TLV的变化显著减小。接受PD治疗的患者TKV和TLV的增加幅度大于接受HD治疗的患者。
