Abstract
The choice of modality for renal replacement therapy in patients with ADPKD varies, often based on patient choice, physician-related factors, and resource availability. For a long time peritoneal dialysis (PD) was considered as relative contraindication due to the possible limited intraperitoneal space. In recent years, some studies suggested it is a valid option also in patients with ADPKD to be considered as a first line treatment in potentially fit patients. Diuresis volume lowering and potential permanent damage of peritoneal integrity, both leading to a necessary switch to haemodialysis, are the two most important dangers after nephrectomy, especially if bilateral, in PD patients. We performed a retrospective analysis of patient underwent native polycystic kidney nephrectomy in order to state the possibility to recover peritoneal dialysis after surgery.
Highlights
The term polycystic kidney disease should be reserved for two hereditary diseases: autosomal recessive polycystic kidney disease (ADPKD) and, most commonly, autosomal dominant polycystic kidney disease (ADPKD) [1, 2]
Indications for nephrectomy include recurrent and/or severe infection, symptomatic nephrolithiasis, recurrent and/or severe bleeding, intractable pain, suspicion of renal cancer, and space restrictions prior to transplantation (Figure 2), taking into account that kidney size typically declines after transplantation [10,11,12,13]
We considered pre and post-surgery residual diuresis, pre and post nephrectomy creatinine value, the time from the beginning of dialysis to nephrectomy
Summary
The term polycystic kidney disease should be reserved for two hereditary diseases: autosomal recessive polycystic kidney disease (ADPKD) and, most commonly, autosomal dominant polycystic kidney disease (ADPKD) [1, 2]. ADPKD is characterized by relentless development and growth of cysts causing progressive kidney enlargement associated with hypertension, abdominal fullness and pain, episodes of cyst haemorrhage giving rise to gross haematuria, nephrolithiasis, cyst infections, and progressive renal failure (Figure 1) [3]. ADPKD is one of the most common human hereditary diseases and leads to end stage renal disease requiring dialysis or renal transplantation in about 50% of the patients [4, 5]. Indications for nephrectomy include recurrent and/or severe infection, symptomatic nephrolithiasis, recurrent and/or severe bleeding, intractable pain, suspicion of renal cancer, and space restrictions prior to transplantation (Figure 2), taking into account that kidney size typically declines after transplantation [10,11,12,13]
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