P0039IS A NEPHRECTOMY POLYCYSTIC KIDNEY DISEASE NECESSARY FOR PATIENTS WITH END-STAGE CHRONIC KIDNEY DISEASE?

Abstract

Abstract Background and Aims In the structure of end-stage CKD polycystic kidney disease is about 8-10 %. These patients often required preparation for transplantation. In addition, enlarged kidneys are reducing the volume of the abdominal cavity, negative impact on the peritoneal dialysis (PD). Method In 2005-2019 41 nephrectomies were performed in patients with end-stage CKD with polycystic kidney disease: 11 patients have undergone open nephrectomy, 13 patients laparoscopic nephrectomy and 17 retroperitoneoscopic nephrectomy. We analyzed postoperative period and complications, method of treatment end-stage CKD selected in future. In particular, we evaluated the effectiveness of peritoneal dialysis depending on the operating access. Results Complications: intraoperative bleeding was in 3 cases, damage of the spleen was in one. The significantly lower blood loss was in the group of operations performed endoscopic access. Subsequently, 16 patients were treated with hemodialysis (HD), 25 patients PD. The effectiveness of PD was estimated by 3 months and 1 year after start treatment by kt/v. In the group of patients with open nephrectomy, the effectiveness on average was 1.61 and 1.44 respectively. Patients underwent laparoscopic nephrectomy the efficiency is in average of 1.72, and 1.60, retroperitoneoscopic nephrectomy 1.88, 1.72 respectively. The conversion method of PD-treatment to the HD within 6 months after surgery was required in 5 patients (open nephrectomy technique), 2 patients (laparoscopic technique), no one patient (retroperitoneoscopic technique) was not required for the conversion PD to HD. Conclusion Our experience of nephrectomies in patient with end-stage CKD indicate the safety and effectivity of the endoscopic technique and its applicability to patients on PD. Retroperitoneoscopic access has less impact on the effective area of the peritoneum, which is reflected in the subsequent course of PD.