Do Patients with Autosomal Dominant Polycystic Kidney Disease Need Native Nephrectomy before Kidney Transplantation? A Single-Center Retrospective Study over 11 Years.

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-10-14 DOI:10.1159/000548134

Ruiyu Yue, Jingcheng Lyu, Yichen Zhu, Ye Tian

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引用次数: 0

Abstract

Introduction: The aim of the study was to explore whether patients with autosomal dominant polycystic kidney disease (ADPKD) require native nephrectomy prior to kidney transplantation.

Methods: A retrospective analysis of 44 ADPKD patients who received deceased donor allogeneic kidney transplantation at Beijing Friendship Hospital (2013-2024) was conducted. Patients were divided into pre-transplantation nephrectomy (PN) group (n = 29) and a non-PN (nPN) group (n = 15). The pre-transplant general status, surgical duration, intraoperative blood loss, postoperative recovery, and survival rates were compared between the two groups. Additionally, total kidney volume (TKV) and adjusted TKV were used to predict ultimate nephrectomy (UN) status via a receiver operating characteristic (ROC) curve analysis. Finally, the nPN group was subdivided to UN group (n = 8) and non-ultimate nephrectomy (nUN) group (n = 7) based on final nephrectomy status, with comparisons made regarding kidney function and survival analysis.

Results: The nPN group had better long-term survival (62 vs. 38 months, p < 0.001). ROC analysis showed BSA-TKV had the highest predictive accuracy (sensitivity: 69.44%, specificity: 87.50%). Subgroup analysis indicated post-transplant nephrectomy did not impact long-term survival or kidney function.

Conclusion: Pre-transplant nephrectomy in ADPKD patients should be limited to essential cases as it may prolong recovery and reduce survival. Post-transplant nephrectomy is a safer alternative, guided by predictive metrics like BSA-TKV.

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常染色体显性多囊肾病患者在肾移植前需要原生肾切除术吗？一项11年的单中心回顾性研究。

本研究的目的是探讨常染色体显性多囊肾病（ADPKD）患者在肾移植前是否需要进行天然肾切除术。方法：回顾性分析2013-2024年在北京友谊医院接受已故供体异体肾移植的44例ADPKD患者。患者分为移植前肾切除术组（n = 29）和非肾切除术组（n = 15）。比较两组患者移植前一般情况、手术时间、术中出血量、术后恢复情况及生存率。此外，总肾容量（TKV）和调整后的TKV通过受试者工作特征（ROC）曲线分析来预测最终肾切除术（UN）状态。最后，根据最终肾切除术情况将nPN组细分为UN组（n = 8）和非最终肾切除术（nUN）组（n = 7），比较肾功能和生存分析。结果：nPN组有更好的长期生存（62个月vs 38个月，p < 0.001）。ROC分析显示，BSA-TKV预测准确率最高（敏感性69.44%，特异性87.50%）。亚组分析表明，移植后肾切除术不影响长期生存或肾功能。结论：移植前肾切除术可能延长患者的恢复时间，降低患者的生存期，应局限于必要的病例。在BSA-TKV等预测指标的指导下，移植后肾切除术是一种更安全的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.