Case report about three patients affected by autosomal dominant polycystic kidney disease who started peritoneal dialysis after nephrectomy and simultaneous peritoneal catheter implantation.

Abstract

Peritoneal dialysis (PD) initiation can be difficult in patients developing end stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD) when these patients need nephrectomy to prepare kidney transplantation.
Here we describe the cases of 3 adult patients followed in the nephrology ward of Besançon in 2017 and 2018 for ESRD due to ADPKD and who began peritoneal dialysis in the post-operative period following nephrectomy with simultaneous peritoneal catheter implantation. The data were collected retrospectively.
Among the three patients included, all began PD during the first month after being operated on, without requiring hemodialysis. Mean delay between nephrectomy and PD start was 8.7 days. The renal-replacement therapy was begun following a continuous ambulatory PD (CAPD) technique with small volumes (1.5L), then was carried on with automated PD (APD) technique with small volumes. The mean delay between nephrectomy and the establishment of a standard APD program was 24.3 days. No major complications were reported at the establishment of PD, particularly there were no dialysate leaks. On a long term view, technical survival was good since 2 patients are still treated by PD whereas one patient has been transplanted. Adequacy criteria were satisfactory.
To conclude, our group of 3 patients shows very interesting results about PD start in the post-operative period after nephrectomy with simultaneous PD catheter implantation in polycystic patients.