Ersoy ÖKSÜZ, Muhammet Serdar BUĞDAY, Çiğdem BUĞDAY, Aydın TÜRKMEN

Evaluation of post-transplant complications, patientand graft survival in patients with autosomal dominantpolycystic kidney disease after renal transplantation;A single center experience

AbstractAim: Autosomal dominant polycystic kidney disease (ADPKD) is systemic, progressive hereditary disease, characterized by cyst formation in multiple organs. Patients with ADPKD mostly develop end stage renal disease (ESRD) and require renal replacement therapy, preferably renal transplantation (RT). In this study, we aimed to compare the post-RT complications, patient and graft survivals in patients with ADPKD and other etiologies of ESRD. Materials and Methods: We retrospectively evaluated patients’ baseline characteristics, post-RT complications, patient and graft survival in patients with ESRD underwent renal transplantation due to ADPKD and other etiologies. We included 28 patients in ADPKD and 28 patients in the control group. Results: The mean survival time was 224.83 ± 7.53 months in all patients. During follow-up period 1 patient died in both groups and 10 years patients and graft survivals were similar for both groups. The graft survival, acute and chronic rejections and glomerular filtration rate levels were similar in both groups end of the first year of RT but total cholesterol and glucose levels were significantly higher in the ADPKD group. Moreover, developing of ischemic heart disease was significantly higher in ADPKD (32% vs 0%, p=0.002), the other complication rates were similar in both. Conclusion: As a comparesion to patients with ESRD underwent RT due to ADPKD and different etiologies, both groups have similar patient and graft survival rates. Patients with ADPKD after transplantation may have a higher incidence of ischemic heart disease.

PDF

___

1. Torres VE, Harris PC., Pirson, Y. Autosomal dominant polycystic kidney disease. Lancet 2007;369:1287- 301.
2. Harris PC, Torres VE. Polycystic kidney disease. Annu Rev Med 2009;60:321-37.
3. Collins AJ, Kasiske B, Herzog C, et al. Excerpts from the United States Renal Data System 2004 annual data report: atlas of end-stage renal disease in the United States. Am J Kidney Dis 2005;45:5-7, S1-S280. 4. Gabow PA. Autosomal dominant polycystic kidney disease. N Engl J Med 1993;329:332.
5. Shaw C, Simms RJ, Pitcher D, et al. Epidemiology of patients in England and Wales with autosomal dominant polycystic kidney disease and end-stage renal failure. Nephrol Dial Transplant 2014;29:1910– 8.
6. Pirson, Y. Extrarenal manifestations of autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis 2010;17:173-80.
7. Luciano RL, Dahl NK. Extra-renal manifestations of autosomal dominant polycystic kidney disease (ADPKD): considerations for routine screening and management. Nephrol. Dial. Transplant 2014;29:247- 54.
8. Torra R, Sarquella J, Calabia J,et al. Prevalence of cysts in seminal tract and abnormal semen parameters in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2008;3:790-3.
9. Kumar S, Adeva M, King BF, et al. Duodenal diverticulosis in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant 2006;21:3576-8.
10. 1Torres VE, Harris PC. Autosomal dominant polycystic kidney disease: the last 3 years. Kidney Int 2009;76:149.
11. Spithoven EM, Kramer A, Meijer E, et al. Renal replacement therapy for ADPKD in Europe: prevalence and survival. An analysis of data from the ERA-EDTA Registry. Nephrol Dial Transplant. 2014;29:15-25.
12. Schnuelle P, Lorenz D, Trede M, et al. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term followup. J Am Soc Nephrol 1998;9:2135.
13. Hadimeri H, Norden G, Friman S, et al. Autosomal dominant polycystic kidney disease in a kidney transplant population. Nephrol Dial Transplant.1997;12:1431-6.
14. Fitzpatrick PM, Torres VE, Charboneau JW, et al. Longterm outcome of renal transplantation in autosomal dominant polycystic kidney disease. Am J Kidney Dis 1990;15:535-43.
15. Florijn KW, Chang PC, van der Woude FJ, et al. Long-term cardiovascular morbidity and mortality in autosomal dominant polycystic kidney disease patients after renal transplantation. Transplantation 1994;57:73-81.
16. Valderrábano F, Jones EH, Mallick NP. Report on management of renal failure in Europe, XXIV, 1993 Nephrol DialTransplant 1995;10:1-25.
17. Pirson Y, Christophe JL, Goffin E. Outcome of renal replacement therapy in autosomal dominant polycystic kidney disease. 1996; Nephrol Dial Transplant 1996;11:24-8.
18. Shiroyanagi Y, Tanabe K, Hashimoto Y, et al. Kidney transplantation in the recipient with autosomaldominant polycystic kidney disease: a single center experience. Transplant Proceedings 2000;32:1841.
19. Gill JS, Rose C, Pereira BJ, et al. The importance of transitions between dialysis and transplantation in the care of end-stage renal disease patients. Kidney Int 2007;71:442-7.
20. Wang D, Iversen J, Wilcox CS, et al. Endothelial dysfunction and reduced nitric oxide in resistance arteries in autosomal duominant polycystic kidney disease. Kidney Int 2003; 64:1381-8.
21. Kanaan N, Devuyst O, Pirson Y. Renal transplantation in autosomal dominant polycystic kidney disease. Nat Rev Nephrol 2014;10:455-65.
22. Helal I, Reed B, Mettler P, et al. Prevalence of cardiovascular events in patients with autosomal dominant polycystic kidney disease. Am J Nephrol 2012;36:362-70.
23. Ruderman I, Masterson R, Yates C, et al. New onset diabetes after kidney transplantation in autosomal dominant polycystic kidney disease: A retrospective cohort study. Nephrology 2012;17:89-96.
24. Mangray M, Vella JP. Hypertension after kidney transplant. Am J Kidney Dis 2011;57:331-41.
25. Ducloux D, Motte G, Vautrin P, et al. Polycystic kidney disease as a risk factor for post- transplant diabetes mellitus. Nephrol. Dial. Transplant 1999;14:1244-6.
26. de Mattos AM, Olyaei AJ, Prather JC, et al. Autosomaldominant polycystic kidney disease as a risk factor for diabetes mellitus following renal transplantation. Kidney Int 2005;67:714-20.
27. Hamer RA, Chow CL, Ong AC, et al. Polycystic kidney disease is a risk factor for new-onset diabetes after transplantation. Transplantation 2007;83:36-40.
28. Pietrzak-Nowacka M, Safranow K, Rózański J, et al. Autosomal dominant polycystic kidney disease is not a risk factor for post-transplant diabetes mellitus. Matched-pair design multicenter study. Arch Med Res 2008;39,312-9.
29. Barn K, Laftavi M, Pierce D, et al. Low levels of highdensity lipoprotein cholesterol: an independent risk factor for late adverse cardiovascular events in renal transplant recipients. Transpl Int 2010;23:574.
30. Cosio FG, Hickson LJ, Griffin MD, et al. Patient survival and cardiovascular risk after kidney transplantation: the challenge of diabetes. Am J Transplant 2008;8:593.
31. Vareesanggthipp K, Tong P, Wilkinson R, et al. Insulin resistance in adult polycystic kidney disease. Kidney Int 1997;52:503-8.
32. Mangray M, Vella JP. Hypertension after kidney transplant. Am J Kidney Dis 2011;57:331-41.
33. Salehipour M, Jalaeian H, Salahi H, et al. Are large nonfunctional kidneys risk factors for posttransplantation urinary tract infection in patients with end-stage renal disease due to autosomal dominant polycystic kidney disease? Transplant Proc 2007;39:887.
34. Sklar AH, Caruana RJ, Lammers JE, et al. Renal infections in autosomal dominant polycystic kidney disease. Am J Kidney Dis 1987;10:81.
35. Razeghi E, Kaboli A, Pezeshki ML, et al. Risk factors of erythrocytosis post renal transplantation. Saudi J Kidney Dis Transpl 2008;19:559.
36. Einollahi B, Lessan-Pezeshki M, Nafar M, et al. Erythrocytosis after renal transplantation: review of 101 cases. Transplant Proc 2005;37:3101.