Complications of autosomal dominant polycystic kidney disease in 50 haemodialysed patients. A case-control study. The U.C.L. Collaborative Group.

BACKGROUND

The impact of renal and extrarenal manifestations of autosomal dominant polycystic kidney disease (ADPKD) during chronic haemodialysis (HD) has never been assessed in a paired case-control study.

METHODS

Comparison of the course of 50 ADPKD patients with 50 matched control (C) patients who started chronic HD at the same time.

RESULTS

Follow-up averaged 48 and 39 months in the ADPKD and C groups respectively. Actuarial survival was similar in both groups. Prevalence of renal pain (36 vs 2%, P=0.0001), haematuria (36 vs 16%, P<0.03) and renal infection (16 vs 2%, P<0.04) was higher in the ADPKD than in the C group. Nephrectomy during HD was performed in six ADPKD (in 4 cases in preparation for transplantation) and in one control patient. Number of patients with coronary and heart valve complications was similar in both groups. Stroke occurred in three patients from both groups. Only two ADPKD patients experienced a single episode of pain related to liver cyst. Prevalence of severe infection was similar in the ADPKD group (36%) and the C group (28%). Number and duration of hospitalizations were similar in both groups.

CONCLUSIONS

The overall outcome of ADPKD patients on maintenance HD is similar to that of HD patients with other primary renal diseases. Complications related to cystic kidneys are frequent but rarely severe. Extrarenal manifestations of ADPKD have a limited clinical impact in this short-term study.