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Comparison of acquired cystic kidney disease between hemodialysis and continuous ambulatory peritoneal dialysis
1Department of Internal Medicine, Catholic University of Korea, Seoul, Korea.
Insights
The prevalence of acquired cystic kidney disease (ACKD) is similar in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Dialysis duration is the primary factor influencing ACKD development.
Area of Science:
- Nephrology
- Renal Medicine
- Dialysis Therapy
Background:
- Acquired cystic kidney disease (ACKD) is primarily documented in hemodialysis (HD) patients.
- Limited data exists on ACKD prevalence in continuous ambulatory peritoneal dialysis (CAPD) patients.
Purpose of the Study:
- To compare ACKD prevalence between HD and CAPD patients.
- To identify factors associated with ACKD development in dialysis patients.
Main Methods:
- A cross-sectional study included 49 HD and 49 CAPD patients with at least 12 months of dialysis.
- Exclusion criteria included polycystic kidney disease and predialysis acquired cystic kidney disease.
- ACKD diagnosis was based on ultrasonography, defined as ≥3 cysts per kidney.
Main Results:
- Overall ACKD prevalence was 31% with no significant difference between HD (27%) and CAPD (34%) groups.
- ACKD prevalence was not linked to age, sex, primary renal disease, or blood markers (hemoglobin, BUN, creatinine).
- Dialysis duration showed a significant association with ACKD development (p < 0.05).
Conclusions:
- Dialysis modality (HD vs. CAPD) does not influence ACKD prevalence.
- The duration of dialysis is the main determinant for acquired cyst formation.
Objectives:
ACKD has been described mainly in patients treated with hemodialysis(HD), and there are only a few reports about the prevalence of ACKD in continuous ambulatory peritoneal dialysis (CAPD) patients. Therefore, we compared the prevalence of ACKD in patients receiving HD and CAPD, and evaluated the possible factors which may affect the development of ACKD.
Methods:
Forty nine HD and 49 CAPD patients who had received dialysis therapy for at least 12 months were enrolled in this cross-sectional study. Patients who had a past history of polycystic kidney disease and had acquired cystic kidney disease on predialysis sonographic exam were excluded. Detection of ACKD was made by ultrasonography and ACKD was defined as 3 or more cysts in each kidney.
Results:
The prevalence of ACKD was about 31% (30/98) and there was no significant difference between HD and CAPD patients(27% vs. 34%, p > 0.05). The prevalence of ACKD was not associated with age, sex, primary renal disease, the levels of hemoglobin, BUN, and serum creatinine. However, the duration of dialysis was significantly related to the development of ACKD (presence of ACKD, 74.4 +/- 42.4 months vs. absence of ACKD, 37.8 +/- 24.1 months, p < 0.05).
Conclusion:
The prevalence of ACKD is not different according to the mode of dialysis, and the major determinant of acquired cyst formation is duration of dialysis.
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