For patients with end-stage renal disease (ESRD), the optimal choice for renal replacement therapy is renal transplant. A common cause of ESRD is the genetic disorder autosomal dominant polycystic kidney disease (ADPKD). Unlike other causes of ESRD, patients with ADPKD require additional pretransplant evaluation for intracranial aneurisms, cardiac manifestation, and complications involving liver and renal cysts.
Outcomes of kidney transplant in patients with ADPKD in Taiwan are not known. Researchers analyzed data on 1,327 kidney transplant recipients representing 1,382 kidney transplants (two recipients had three transplants and 48 had two transplants) over the past 35 years. Of the total recipients, 41 had ADPKD. The analysis was designed to compare the demographics, outcomes, and complications of transplant in the cohort with ADPKD with the cohort without ADPKD.
In the total cohort, mean recipient age at first transplant was 42.9 years. In the ADPKD cohort, mean age at first transplant was 52.5 years compared with 42.7 years in patients without ADPKD (P=0.001). In the total cohort, 55.8 %of patients were male. In the ADPKD group, 68.3% were male compared with 55.4% in the group without ADPKD; the difference did not reach statistical significance.
The prevalence of new onset diabetes after transplantation was higher in the ADKPD group compared with the non-ADPKD group (51.2% vs 25.3%; P=0.005). There was also a higher rate of malignancy in the ADKPD group than in the non-ADPKD group (43.9% vs 28.0%; P=0.041). Patient survival was inferior in the ADPKD group (38.9% vs 70.3%; P=0.018).
The researchers said, “Further research with multiple centers and greater numbers of patients are needed to compare more precisely the complications and results of transplant between patients with ADPKD and other recipients in Taiwan.”
Source: Chen C-H, Yu T-M, Chaung YU-W. Outcome of kidney transplantation in patients with polycystic kidney disease: A single-center study. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2019 (Abstract TH-PO859), November 7, 2019, Washington, DC.