Efficacy and prognosis of peritoneal dialysis in patients with end-stage polycystic kidney disease

Objective To analyze the therapeutic effect and prognosis of peritoneal dialysis in patients with end-stage polycystic kidney disease. Methods A retrospective analysis was performed on patients with polycystic kidney disease who were treated with peritoneal dialysis for more than 3 months between July 2007 and September 2016 in the Second Hospital Affiliated to Soochow University. A total of 45 patients were enrolled in this study. Another 45 patients of non-diabetic nephropathy were selected as the control group matched by gender, age, and time of PD initiation. The information of the two groups such as general data, dialysis related complications, incidence of peritonitis, prognosis was recorded. Survival analysis was performed using the Kaplan-Meier method and Log-rank test．The risk factors affecting patients' survival were analyzed with Cox regression model. Results There were no significant difference in pre-dialysis age, sex ratio, blood pressure, urine volume, body weight, eGFR, biochemical data, and the proportion of hypertension and diabetes mellitus in the polycystic kidney group and control group. 24 h ultra-filtration volume, 4 h D/Pcr, Kt/V and Ccr between the two groups showed no significant difference (all P＞0.05). The incidence of peritonitis and the time of the first peritonitis in the two groups respectively as one episode per 82.4 months vs one episode per 81.5 months, (35.8±22.8) months vs (34.5±20.9) months had no statistical difference. The ratio of hernia (6.6% vs 2.2%), thoracic and abdominal leakage (4.4% vs 2.2%), dialysate leakage (0 vs 0), catheter dysfunction (4.4% vs 6.6%), exit-site infections (11.1% vs 6.6%), tunnel infections (4.4% vs 2.2%) and non PD related infections (11.1% vs 13.3%) had no significant difference. The 1-year, 3-year, 5-year patient survival of two groups respectively were 95.2% vs 93.3%, 78.9% vs 75.0%, 67.6% vs 64.9% (P=0.475), and 5-year technique survival was 78.7% vs 76.7% (P=0.623), demonstrating no obvious difference. Cox regression analysis showed that age and serum albumin were risk factors for the survival of patients. Conclusions The effect and prognosis of peritoneal dialysis in patients with polycystic kidney and non polycystic kidney were similar. Peritoneal dialysis is not the contraindication of polycystic kidney. Peritoneal dialysis can be used as a routine renal replacement therapy in patients with polycystic kidney disease.