Fadi George Munairdjy Debeh, Ahmad Ghanem, Vineetha Rangarajan, Abdul Hamid Borghol, Stefan Paul, Bassel AlKhatib, Nay Nader, Marie Therese Bou Antoun, Dana Hanna, Levon Souvalian, Zhuo Li, Adriana Gregory, Timothy Kline, Michael M Mao, Sandhya Manohar, Ivan E Porter, John J Dillon, Andrea Kattah, Sayeed Khalillullah, Lyle W Baker, Christopher L Trautman, LaTonya J Hickson, Fouad T Chebib, Nabeel Aslam
{"title":"腹膜透析治疗ADPKD的多中心研究：累积囊性器官体积在治疗并发症中的作用。","authors":"Fadi George Munairdjy Debeh, Ahmad Ghanem, Vineetha Rangarajan, Abdul Hamid Borghol, Stefan Paul, Bassel AlKhatib, Nay Nader, Marie Therese Bou Antoun, Dana Hanna, Levon Souvalian, Zhuo Li, Adriana Gregory, Timothy Kline, Michael M Mao, Sandhya Manohar, Ivan E Porter, John J Dillon, Andrea Kattah, Sayeed Khalillullah, Lyle W Baker, Christopher L Trautman, LaTonya J Hickson, Fouad T Chebib, Nabeel Aslam","doi":"10.34067/KID.0000000888","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disorder and the fourth leading cause of kidney failure (KF). Peritoneal dialysis (PD). Preferred for its home-based convenience and cost-effectiveness, is often underutilized in ADPKD due to concerns over enlarged kidneys and heightened complications risks.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Mayo Clinic PKD Database to evaluate individuals with ADPKD undergoing PD. We analyzed demographics, clinical parameters, and PD-related parameters. Complications were correlated with kidney and liver volumes derived from pre-KF imaging.</p><p><strong>Results: </strong>A total of 155 individuals with ADPKD on PD were included, of whom 45.1% were male. The mean age at PD initiation was 54.3 ± 12.8 years and the mean BMI was 28.0 ± 7.0 Kg/m2. The median duration of PD was 24.3 months (IQR, 10.7-43.1), with 21.9% transitioning to hemodialysis. The most common complications were abdominal hernias (30.3%) and peritonitis (23.9%), with a peritonitis rate of 0.11 episodes per patient-year. Imaging analyses was performed on a subset of 50 patients, showed a median height-adjusted total kidney liver volume (htTKLV) of 2731.9 mL/m (IQR, 2102.5-3131.1) and a median height-adjusted total kidney volume (htTKV) of 1303.5 mL/m (IQR, 733.1-1829.4). Kaplan-Meier analysis demonstrated no differences in complications rates based on htTKLV or htTKV (above vs. below median values) or BMI categories. Multivariate Cox regression analysis revealed that higher height-adjusted cumulative organ volume was associated with a lower risk of PD-related complications (hazard ratio = 0.56, p = 0.026).</p><p><strong>Conclusions: </strong>Peritoneal dialysis (PD) is a safe and feasible treatment option for ADPKD patients, with no increased risk of PD-related complications associated with larger height-adjusted cumulative organ volumes. Infectious complication rates in this cohort were within ISPD guideline thresholds further supporting the safety of PD in this population.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multicenter Insights into Peritoneal Dialysis for ADPKD: Role of Cumulative Cystic Organ Volumes in Treatment Complications.\",\"authors\":\"Fadi George Munairdjy Debeh, Ahmad Ghanem, Vineetha Rangarajan, Abdul Hamid Borghol, Stefan Paul, Bassel AlKhatib, Nay Nader, Marie Therese Bou Antoun, Dana Hanna, Levon Souvalian, Zhuo Li, Adriana Gregory, Timothy Kline, Michael M Mao, Sandhya Manohar, Ivan E Porter, John J Dillon, Andrea Kattah, Sayeed Khalillullah, Lyle W Baker, Christopher L Trautman, LaTonya J Hickson, Fouad T Chebib, Nabeel Aslam\",\"doi\":\"10.34067/KID.0000000888\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disorder and the fourth leading cause of kidney failure (KF). Peritoneal dialysis (PD). Preferred for its home-based convenience and cost-effectiveness, is often underutilized in ADPKD due to concerns over enlarged kidneys and heightened complications risks.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Mayo Clinic PKD Database to evaluate individuals with ADPKD undergoing PD. We analyzed demographics, clinical parameters, and PD-related parameters. Complications were correlated with kidney and liver volumes derived from pre-KF imaging.</p><p><strong>Results: </strong>A total of 155 individuals with ADPKD on PD were included, of whom 45.1% were male. The mean age at PD initiation was 54.3 ± 12.8 years and the mean BMI was 28.0 ± 7.0 Kg/m2. The median duration of PD was 24.3 months (IQR, 10.7-43.1), with 21.9% transitioning to hemodialysis. The most common complications were abdominal hernias (30.3%) and peritonitis (23.9%), with a peritonitis rate of 0.11 episodes per patient-year. Imaging analyses was performed on a subset of 50 patients, showed a median height-adjusted total kidney liver volume (htTKLV) of 2731.9 mL/m (IQR, 2102.5-3131.1) and a median height-adjusted total kidney volume (htTKV) of 1303.5 mL/m (IQR, 733.1-1829.4). Kaplan-Meier analysis demonstrated no differences in complications rates based on htTKLV or htTKV (above vs. below median values) or BMI categories. Multivariate Cox regression analysis revealed that higher height-adjusted cumulative organ volume was associated with a lower risk of PD-related complications (hazard ratio = 0.56, p = 0.026).</p><p><strong>Conclusions: </strong>Peritoneal dialysis (PD) is a safe and feasible treatment option for ADPKD patients, with no increased risk of PD-related complications associated with larger height-adjusted cumulative organ volumes. Infectious complication rates in this cohort were within ISPD guideline thresholds further supporting the safety of PD in this population.</p>\",\"PeriodicalId\":17882,\"journal\":{\"name\":\"Kidney360\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney360\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34067/KID.0000000888\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney360","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34067/KID.0000000888","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Multicenter Insights into Peritoneal Dialysis for ADPKD: Role of Cumulative Cystic Organ Volumes in Treatment Complications.
Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disorder and the fourth leading cause of kidney failure (KF). Peritoneal dialysis (PD). Preferred for its home-based convenience and cost-effectiveness, is often underutilized in ADPKD due to concerns over enlarged kidneys and heightened complications risks.
Methods: This retrospective cohort study utilized data from the Mayo Clinic PKD Database to evaluate individuals with ADPKD undergoing PD. We analyzed demographics, clinical parameters, and PD-related parameters. Complications were correlated with kidney and liver volumes derived from pre-KF imaging.
Results: A total of 155 individuals with ADPKD on PD were included, of whom 45.1% were male. The mean age at PD initiation was 54.3 ± 12.8 years and the mean BMI was 28.0 ± 7.0 Kg/m2. The median duration of PD was 24.3 months (IQR, 10.7-43.1), with 21.9% transitioning to hemodialysis. The most common complications were abdominal hernias (30.3%) and peritonitis (23.9%), with a peritonitis rate of 0.11 episodes per patient-year. Imaging analyses was performed on a subset of 50 patients, showed a median height-adjusted total kidney liver volume (htTKLV) of 2731.9 mL/m (IQR, 2102.5-3131.1) and a median height-adjusted total kidney volume (htTKV) of 1303.5 mL/m (IQR, 733.1-1829.4). Kaplan-Meier analysis demonstrated no differences in complications rates based on htTKLV or htTKV (above vs. below median values) or BMI categories. Multivariate Cox regression analysis revealed that higher height-adjusted cumulative organ volume was associated with a lower risk of PD-related complications (hazard ratio = 0.56, p = 0.026).
Conclusions: Peritoneal dialysis (PD) is a safe and feasible treatment option for ADPKD patients, with no increased risk of PD-related complications associated with larger height-adjusted cumulative organ volumes. Infectious complication rates in this cohort were within ISPD guideline thresholds further supporting the safety of PD in this population.
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