Results of nephrectomy in patients with autosomal dominant polycystic kidney disease

Background. Nephrectomy in patients with polycystic kidney disease (PKD) is indicated in cases of hematuria, pain, hypertension, infections or before a renal transplant. The purpose of this study is to report our results of this procedure during a contemporary period of time in patients with PKD. Materials and methods. The study consists on a retrospective of files from patients with PKD, including all cases with unilateral or bilateral nephrectomy. We analyzed general data and compared the results from the surgical procedure between bilateral nephrectomy, unilateral nephrectomy and 2 staged bilateral nephrectomy. Results. A total of 14 PKD patients treated with nephrectomy where gathered. Mean patient age was 46 years; 78.5% has chronic renal insufficiency treated with dialysis. The decision of surgery was based predominantly on the presence of two or more symptoms. A total of 24 procedures where done; 7 patients with simultaneous bilateral nephrectomy, 3 with bilateral nephrectomy done in 2 different stages and 4 patients with unilateral nephrectomy. Good operative results where observed with minimal complications. Bilateral simultaneous nephrectomy was completed in a longer time interval than unilateral procedure (255 vs. 195 min, p = 0.008) and with a slight more bleeding (775 vs. 400cc, p = 0.008). Conclusions. Open nephrectomy remains as the standard procedure for patients with polycystic kidney disease (PKD). Although minimal operative differences where seen between unilateral or bilateral 2 stage nephrectomy and bilateral simultaneous nephrectomy, the overall morbidity was similar between procedures.