COMPLICATIONS OF AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY-DISEASE IN 50 HEMODIALYZED PATIENTS - A CASE-CONTROL STUDY

Background. The impact of renal and extrarenal manifestations of autos omal dominant polycystic kidney disease (ADPKD) during chronic haemodi alysis (HD) has never been assessed in a paired case-control study. Me thods. Comparison of the course of 50 ADPKD patients with 50 matched c ontrol (C) patients who started chronic HD at the same time. Results. Follow-up averaged 48 and 39 months in the ADPKD and C groups respecti vely. Actuarial survival was similar in both groups. Prevalence of ren al pain (36 vs 2%, P=0.0001), haematuria (36 vs 16%, P<0.03) and renal infection (16 vs 2%, P<0.04) was higher in the ADPKD than in the C gr oup. Nephrectomy during HD was performed in six ADPKD (in 4 cases in p reparation for transplantation) and in one control patient. Number of patients with coronary and heart valve complications was similar in bo th groups. Stroke occurred in three patients from both groups, Only tw o ADPKD patients experienced a single episode of pain related to liver cyst. Prevalence of severe infection was similar in the ADPKD group ( 36%) and the C group (28%). Number and duration of hospitalizations we re similar in both groups. Conclusions. The overall outcome of ADPKD p atients on maintenance HD is similar to that of HD patients with other primary renal diseases. Complications related to cystic kidneys are f requent but rarely severe. Extrarenal manifestations of ADPKD have a l imited clinical impact in this short-term study.