Autosomal dominant polycystic kidney disease--the patient on renal replacement therapy.

In Europe approximately 6% of all patients on chronic renal replacement therapy suffer from polycystic kidney disease. Survival of patients with polycystic kidney disease on renal replacement therapy is better than for other primary renal diseases, despite a similar cardiovascular risk profile. We documented a significantly higher erythropoietin level in polycystic patients even in advanced uraemia and on dialysis. A better haemoglobin level seems to improve long-term survival because of a possible beneficial effect on cardiac function. There is no increased risk of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease. Polycystic patients on dialysis should be followed for cardiac valve abnormalities and cerebral aneurysms.