ADPKD Linked to Lower Mortality in Peritoneal Dialysis Patients

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Among patients on peritoneal dialysis, the odds of death are 32% lower among those with vs without autosomal dominant polycystic kidney disease, meta-analysis finds.
Among patients on peritoneal dialysis, the odds of death are 32% lower among those with vs without autosomal dominant polycystic kidney disease, meta-analysis finds.
The following article is part of conference coverage from the NKF 2018 Spring Clinical Meetings in Austin hosted by the National Kidney Foundation. Renal & Urology News staff will be reporting on medical studies conducted by nephrologists and other specialists who are tops in their field in chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from NKF 2018.

AUSTIN, Texas—Patients with autosomal dominant polycystic kidney disease (ADPKD) who are on peritoneal dialysis (PD) have a lower death risk than non-ADPKD patients on PD, findings from a new meta-analysis presented at the National Kidney Foundation's 2018 Spring Clinical Meetings suggest.

The meta-analysis, which was presented by first author Boonphiphop Boonpheng, MD, of East Tennessee University in Johnson City, included 12 observational studies with a total of 14,673 patients on PD (931 with and 13,742 without ADPKD). Compared with the non-ADPKD group, the patients with ADPKD had a significant 32% decreased odds in a pooled analysis. The investigators found no significant associations between ADPKD status and the risks of technique failure or peritonitis.

Separately, in a 12-year study presented at the 2018 Annual Dialysis Conference in Orlando, Florida, researchers found lower mortality rates among patients with vs without ADPKD regardless of whether their initial ESRD treatment modality was PD (17.4% vs 24.7%) or intermittent hemodialysis (26.8% vs 39%).

In patients with ADPKD-associated ESRD, enlarged polycystic kidneys within the peritoneal cavity raise concerns about increased risks of abdominal hernia and dialysate leak related to increased abdominal pressure, senior author Wisit Cheungpasitporn, MD, of the University of Mississippi Medical Center in Jackson, explained. “However, in our meta-analysis, we demonstrated that the risk of technique failure was not significantly different between ADPKD patients and non-ADPKD patients on PD,” he told Renal & Urology News. “Thus, notably, the concerns about increased risks of abdominal hernia and dialysate leak did not translate to higher technique failure of PD requiring the need to transfer to hemodialysis.”

Dr Cheungpasitporn noted that the follow-up time for all studies included in this meta-analysis was less than 5 years, which is relatively short. Consequently, future studies are required if survival benefits of PD over hemodialysis among ESRD patients with ADPKD may decrease over time.

See more coverage from the National Kidney Foundation Spring Clinical meeting

Reference

Boonpheng B, Thongprayoon C, Wijarnpreecha K, et al. Outcomes of patients with autosomal dominant polycystic kidney disease on peritoneal dialysis: A meta-analysis. Data presented at the National Kidney Foundation's 2018 Spring Clinical Meetings, held from April 10-14. Poster 290.

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