Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease: Our Experience Based on 35-Years Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Diagnosis of Diabetes Mellitus (DM), NODAT and ADPKD
2.4. Outcome Assessment
2.5. Statistical Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Without ADPKD (n = 1286) | With ADPKD (n = 41) | Total (n = 1327) | p Value | ||||
---|---|---|---|---|---|---|---|
Age (yrs) (Mean ± SD) | 42.7 ± 12.7 | 48.6 ± 10.8 | 42.9 ± 12.6 | 0.005 | |||
Male gender | 713 (55.4%) | 28 (68.3%) | 741 (55.8%) | 0.141 | |||
Vintage of RTx (yrs) | 10.6 (5.8–16.4) | 12.0 (5.4–18.2) | 10.6 (5.8–16.5) | 0.740 | |||
Duration of follow-up (yrs) | 11.6 ± 7.4 | 12.0 ± 7.7 | 11.6 ± 7.4 | 0.802 | |||
Systolic blood pressure (mmHg) | 144.3 ± 15.3 | 145.3 ± 10.2 | 144.4 ± 22.6 | 0.903 | |||
Diastolic blood pressure (mmHg) | 85.3 ± 10.2 | 88.6 ± 11.3 | 85.4 ± 15.2 | 0.123 | |||
Body height (cm) | 163.8 ± 7.2 | 162.2 ± 7.3 | 162.9 ± 8.3 | 0.832 | |||
Body weight (kg) | 62.3 ± 10.3 | 63.3 ± 11.3 | 62.2 ± 12.6 | 0.863 | |||
Body mass index (kg/m2) | 23.3 ± 4.0 | 22.3 ± 3.9 | 23.4 ± 3.8 | 0.993 | |||
Blood urea nitrogen (mg/dL) | 52.9 ± 23.2 | 53.8 ± 22.5 | 52.5 ± 26.8 | 0.863 | |||
Serum creatinine (mg/dL) | 1.29 ± 0.6 | 1.30 ± 0.3 | 1.3 ± 0.4 | 0.756 | |||
White blood cell (/μL) | 11069 ± 4063 | 11630 ± 6530 | 11016.2 ± 4759.3 | 0.756 | |||
Hemoglobin (g/dL) | 10.4 ±3.0 | 10.3 ± 1.1 | 10.3 ± 2.3 | 0.856 | |||
Neutrophil (%) | 84.3 ± 11.0 | 83.9 ± 9.3 | 84.5 ± 11.6 | 0.746 | |||
Platelet (×103/μL) | 197.3 ± 69.3 | 196.3 ± 66.3 | 196.5 ± 73.7 | 0.456 | |||
Uric acid (mg/dL) | 6.3 ± 3.0 | 6.1 ± 1.9 | 6.2 ± 2.1 | 0.896 | |||
K (meq/L) | 4.4 ± 0.2 | 4.3 ± 0.2 | 4.4 ± 0.8 | 0.846 | |||
Ca (mg/dL) | 8.3 ± 2.0 | 8.1 ± 0.9 | 8.1 ± 1.5 | 0.635 | |||
P (mg/dL) | 4.4 ±1.0 | 4.2 ± 0.9 | 4.3 ± 1.9 | 0.456 | |||
Blood albumin (g/dL) | 3.9 ± 0.7 | 3.8 ± 0.8 | 3.9 ± 0.6 | 0.674 | |||
Total protein (g/dL) | 6.5 ± 0.8 | 6.4 ± 1.5 | 6.4 ± 1.0 | 0.456 | |||
Aspartate transaminase (U/L) | 24 ± 12.6 | 22.9 ± 10.3 | 23.0 ± 16.5 | 0.697 | |||
Alanine transaminase (U/L) | 23.8 ±24 | 24.9 ± 15.3 | 25.3 ± 28.2 | 0.623 | |||
Total cholesterol (mg/dL) | 190.8 ± 63.3 | 188 ± 42.2 | 189.7 ± 52.6 | 0.296 | |||
Triglyceride (mg/dL) | 149 ± 80 | 135 ± 68 | 138.7 ± 100.0 | 0.753 | |||
Low-density lipoprotein (mg/dL) | 110.9 ± 50.3 | 112 ± 33.9 | 111.7 ± 42.1 | 0.2698 | |||
High-density lipoprotein (mg/dL) | 53.7 ± 20.3 | 51.9 ± 22.3 | 52.0 ± 17.5 | 0.963 | |||
Blood glucose (mg/dL) | 135.9 ± 60.2 | 134.8 ± 70.2 | 135.8 ± 71.0 | 0.756 | |||
Glycated hemoglobin (%) | 6.3 ± 2.0 | 6.1 ± 2.3 | 6.1 ± 1.3 | 0.369 | |||
Urinary protein-creatinine ratio (g/g creatinine) | 0.59 ± 2.0 | 0.62 ± 2.3 | 0.6 ± 1.7 | 0.458 | |||
Urinary albumin-creatinine ratio (mg/g creatinine) | 254.9 ± 300.2 | 255 ± 720 | 256.8 ± 780.9 | 0.692 | |||
Alkaline phosphatase (U/L) | 88.2 ± 56.3 | 89.3 ± 77.2 | 89.1 ± 65.4 | 0.752 | |||
Direct bilirubin (mg/dL) | 0.1 ± 0.09 | 0.1 ± 0.03 | 0.1 ± 0.1 | 0.647 | |||
Total bilirubin (mg/dL) | 0.4 ± 0.18 | 0.4 ± 0.2 | 0.4 ± 0.2 | 0.745 | |||
γ-Glutamyl transpeptidase (U/L) | 95.08 ± 89.2 | 94.0 ± 85 | 94.9 ± 110.9 | 0.852 | |||
Alpha-fetoprotein (ng/mL) | 4.9 ± 3.8 | 4.9 ± 4.0 | 4.9 ± 4.1 | 0.951 | |||
Carcinoembryonic antigen (ng/mL) | 1.98 ± 0.98 | 2.0 ± 0.74 | 2.0 ± 1.0 | 0.364 | |||
Carbohydrate antigen 199 (U/mL) | 13.8 ± 9.8 | 13.1 ± 8.3 | 13.2 ± 11.9 | 0.458 | |||
Cancer antigen 125 (U/mL) | 35.9 ± 35 | 33.8 ± 23 | 33.9 ± 40.0 | 0.856 | |||
Death f | 85 | (6.6%) | 8 | (19.5%) | 93 | (7.0%) | 0.006 |
Diabetes mellitus | 439 | (34.1%) | 21 | (51.2%) | 460 | (34.7%) | 0.036 |
Before RTx f | 113 | (8.8%) | 2 | (4.9%) | 115 | (8.7%) | 0.573 |
After RTx | 326 | (25.3%) | 19 | (46.3%) | 345 | (26.0%) | 0.005 |
Onset after RTX (days) | 986 ± 835.2 | 1100 ± 9302 | 1088.5 ± 1069.1 | 0.5866 | |||
Cancer | 360 | (28.0%) | 18 | (43.9%) | 378 | (28.5%) | 0.041 |
Before RTx f | 53 | (4.1%) | 4 | (9.8%) | 57 | (4.3%) | 0.095 |
After RTx | 307 | (23.9%) | 14 | (34.1%) | 321 | (24.2%) | 0.184 |
Cell-mediated rejection | 335 | 26.0% | 12 | (29.3%) | 347 | 26.1% | <0.001 |
Antibody-mediated rejection | 99 | 7.0% | 9 | (22.0%) | 99 | 7.5% | <0.001 |
Hemodialysis | 598 | (47.8%) | 40 | (88.9%) | 638 | (47.6%) | 0.026 |
Peritoneal dialysis | 155 | (11.6%) | 5 | (11.1%) | 160 | (11.9%) | 0.805 |
Hematuria | 10 | (0.78%) | 15 | (36.6%) | 25 | (1.9%) | 0.045 |
Flank pain | 15 | (0.66%) | 10 | (24.4%) | 25 | (1.9%) | 0.036 |
Fullness sensation | 20 | 1.6% | 3 | 7.3% | 23 | 1.7% | 0.563 |
Return to hemodialysis | 271 | 20.3% | 12 | 29.3% | 283 | 21.3% | <0.001 |
Univariate Analysis | Multivariate Analysis (Model 1) | Multivariate Analysis (Model 2) | |||||||
---|---|---|---|---|---|---|---|---|---|
HR | (95% CI) | p Value | HR | 95% CI | p Value | HR | 95% CI | p Value | |
Age | 1.10 | (1.08–1.12) | <0.001 ** | 1.09 | (1.07–1.12) | <0.001 ** | 1.09 | (1.07–1.11) | <0.001 ** |
Sex (M vs. F) | 1.05 | (0.70–1.58) | 0.818 | 1.06 | (0.70–1.60) | 0.796 | 1.05 | (0.69–1.59) | 0.830 |
DM | 1.88 | (1.25–2.83) | 0.003 ** | 1.24 | (0.81–1.89) | 0.314 | 1.27 | (0.83–1.94) | 0.263 |
Polycystic kidney disease (PKD) | 2.34 | (1.13–4.83) | 0.022 * | 1.75 | (0.84–3.65) | 0.137 | |||
Group | |||||||||
No ADPKD | reference | reference | |||||||
Polycystic after RTX | 1.17 | (0.37–3.72) | 0.788 | 1.13 | (0.35–3.62) | 0.838 | |||
Polycystic before RTX | 5.73 | (2.29–14.35) | <0.001 ** | 2.64 | (1.03–6.76) | 0.044 * |
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Tsai, T.-Y.; Chen, C.-H.; Wu, M.-J.; Tsai, S.-F. Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease: Our Experience Based on 35-Years Follow-Up. Diagnostics 2022, 12, 1174. https://doi.org/10.3390/diagnostics12051174
Tsai T-Y, Chen C-H, Wu M-J, Tsai S-F. Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease: Our Experience Based on 35-Years Follow-Up. Diagnostics. 2022; 12(5):1174. https://doi.org/10.3390/diagnostics12051174
Chicago/Turabian StyleTsai, Tsung-Yin, Cheng-Hsu Chen, Ming-Ju Wu, and Shang-Feng Tsai. 2022. "Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease: Our Experience Based on 35-Years Follow-Up" Diagnostics 12, no. 5: 1174. https://doi.org/10.3390/diagnostics12051174