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End-Stage Renal Disease in Patients with Autosomal Dominant Polycystic Kidney Disease

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Polycystic Kidney Disease

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Abstract

Autosomal dominant polycystic kidney disease (ADPKD) accounts for approximately 5–10% of end-stage renal disease (ESRD) cases and is the fourth leading cause for kidney failure worldwide. Half of patients with ADPKD reach ESRD by age 60 requiring the need for some form of renal replacement therapy. This chapter describes the changing incidence and prevalence of kidney dialysis and transplantation for patients with ADPKD and discusses the various issues around renal replacement therapy, focusing on aspects related to clinical management. The choice of dialysis modality, management of anemia and anticoagulation, hypertension, and ongoing renal and extrarenal complications of ADPKD are some potential concerns for those starting dialysis. Although hemodialysis and peritoneal dialysis are both appropriate options, kidney transplantation remains the preferred choice if possible. Transplant-related issues for patients with ADPKD include the selection of living kidney donors from relatives, the risk of alloimmunization, the indication and timing for native nephrectomy, and the choice of immunosuppression. Overall, the outcomes of patients with ADPKD are favorable on dialysis and kidney transplantation compared to other patients reaching ESRD.

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Author information

Authors and Affiliations

  1. McGill University Health Centre, Montreal, QC, Canada

    Ahd Al Khunaizi

  2. Division of Nephrology, Department of Medicine, McGill University Health Centre, Royal Victoria Hospital, Montreal, QC, Canada

    Ahsan Alam MD, MS, FRCPC

Authors
  1. Ahd Al Khunaizi
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  2. Ahsan Alam MD, MS, FRCPC
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Corresponding author

Correspondence to Ahsan Alam MD, MS, FRCPC .

Editor information

Editors and Affiliations

  1. John Gammill Professor in Polycystic Kidney Disease, Chief, Section of Nephrology and Hypertension, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA

    Benjamin D. Cowley, Jr.

  2. Federal Express Chair of Excellence, Chief, Division of Nephrology, Department of Pediatrics, Director, Tuberous Sclerosis Center of Excellence at Le Bonheur Children’s Hospital, Medical Director, Nephrology St. Jude Children’s Research Hospital, University of Tennessee Health Science Center, Children’s Foundation Research Center, Memphis, Tennessee, USA

    John J. Bissler

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Al Khunaizi, A., Alam, A. (2018). End-Stage Renal Disease in Patients with Autosomal Dominant Polycystic Kidney Disease. In: Cowley, Jr., B., Bissler, J. (eds) Polycystic Kidney Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7784-0_14

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  • DOI: https://doi.org/10.1007/978-1-4939-7784-0_14

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  • Online ISBN: 978-1-4939-7784-0

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