Peritoneal dialysis in patients with polycystic kidney disease

Abstract

In Austria, patients with end-stage renal disease caused by polycystic kidney disease are less frequently treated with peritoneal dialysis (PD) than patients with noncystic renal diseases (6% versus 8%). In contrast, the United States renal data system reports that more than one fifth of patients with polycystic kidney disease choose PD as their initial form of renal replacement therapy. The reasons for this difference are unknown. Extrarenal manifestations of the disease, such as diverticulosis, development of hernias or vascular aneurysms, may theoretically promote the occurrence of complications typically related to PD. However, studies undertaken to clarify these questions did not find any difference in the rates of peritonitis caused by diverticulosis or Gram-negative bacteria, and no differences were seen with respect to vascular complications. Nevertheless, in comparison with the general population, patients with polycystic kidney disease are more likely to develop hernias, and the incidence of herniation may be further increased by PD. In conclusion, patients with polycystic kidney disease who also have abdominal complaints such as meteorism and discomfort, or lumbago resulting from the markedly enlarged kidneys, should not be actively advised to have PD treatment. The same is true for patients with recurrent hernias. However, the technical survival, quality of dialysis, duration of therapy and rates of complications in PD are comparable in patients with cystic or noncystic kidney disease, and therefore all patients with polycystic kidney disease who do not have abdominal complaints or history of recurrent hernias should be informed that PD is an adequate form of renal replacement therapy, equally effective as hemodialysis.

Automated Peritoneal Dialysis is Suitable for Polycystic Kidney Disease Patients with End-Stage Renal Disease

“…The report of Shanghai Renal Registry [ 2 ] shows that patients with ESRD caused by PKD are less frequently treated with PD than patients with noncystic renal diseases (7.5 vs. 24.1%). In contrast, USRDS reports that more than 20% of PKD patients choose PD as their initial form of renal replacement therapy, while only 15% are shown in non-PKD renal failure patients [ 3 ].…”

Repeat peritonitis in peritoneal dialysis : A cohort study

“…[16][17][18] Enfin, comme l'indiquent un certain nombre d'études, une vigilance accrue et un retraining du personnel médical et infirmier et des patients sont obligatoires pour prévenir la survenue d'une péritonite en DP. [19,20]…”

Comparative Study of Outcomes among Patients with Polycystic Kidney Disease on Hemodialysis and Peritoneal Dialysis

“…The complications of PCKD such as enlarged kidneys and liver, diverticulosis, and the development of hernias or vascular aneurysms may theoretically prevent the choice of PD among patients with ESRD and PCKD. However, the technical survivals, quality of dialysis, duration of therapy and rates of complications for PD have been reported to be comparable in both patients with and without PCKD 7 8 9 . In addition, PD has been reported to be more frequently used and to be associated with a significantly better adjusted survival in patients with ESRD and PCKD than in those with other causes of ESRD in the United States 10 11 .…”