CAPD in patients with autosomal dominant polycystic kidney disease

Objective: To investigate whether there are specific complications to continuous ambulatory peritoneal dialysis (CAPD) in patients with autosomal dominant polycystic kidney disease (ADPKD) due to defects in various wall structures - causing hernia and diverticulitis - and to enlarged kidneys. Design:The clinical experience of CAPD in 26 patients with ADPKD, treated for 11 +/- 6 months, was studied in retrospect and compared with that of 26 contemporary controls. Medical records were reviewed with respect to survival in this treatment form and any complication. Peritoneal dialysis capacity (PDC), as measured in 21 ADPKD patients and 20 controls, was also evaluated. Setting: University Hospital. Results: Before initiation of CAPD, enlarged kidneys necessitated nephrectomy in 2 of 26 ADPKD patients; both cases were registered as preparation for transplantation, not for CARD. Survival in CAPD was similar in ADPKD patients and controls. Hernia was present in 4 ADPKD patients and 2 controls, and required transfer to hemodialysis in 1 patient from each group, temporarily. The incidence of peritonitis was I per 20 months in ADPKD patients versus 1 in 27 months in the controls, not significantly different. Peritonitis was caused by colonic bacteria in similar numbers. Residual renal function was 1.9 +/- 2.1 mL/min per 1.73 m(2) in ADPKD patients versus 1.9 +/- 1.4 mllmin per 1.73 m(2) in the controls. No difference was detected in any of the variables measured by PDC. Conclusion: There were no specific problems related to ADPKD.