Mayo Clin Proc Innov Qual Outcomes. 2023 Feb;7(1): 69-80
Tatsuya Suwabe,
Yoshifumi Ubara,
Yuki Oba,
Hiroki Mizuno,
Daisuke Ikuma,
Masayuki Yamanouchi,
Akinari Sekine,
Kiho Tanaka,
Eiko Hasegawa,
Junichi Hoshino,
Naoki Sawa.
Objective: To examine the changes in total kidney volume (TKV) and total liver volume (TLV) before and after dialysis initiation in patients with autosomal dominant polycystic kidney disease.
Patients and Methods: This was a retrospective, single-center cohort study to investigate the changes in TKV and TLV before and after dialysis initiation, along with influencing factors, using linear mixed models. We enrolled 95 patients with autosomal dominant polycystic kidney disease (85 receiving hemodialysis [HD] and 10 receiving peritoneal dialysis [PD]) who began receiving dialysis at Toranomon Hospital from January 1, 2008, to December 31, 2020.
Results: The least squares mean TKV ratio (TKV at each time point/TKV at dialysis initiation) was 63.8% (95% confidence interval [CI], 54.7%-72.9%) at 6 years before dialysis initiation and 95.5% (95% CI, 82.9%-108.2%) at 6 years after dialysis initiation (P<.001). A multivariate linear mixed model analysis revealed that dialysis style (HD or PD) had the strongest effect on changes in TKV (P=.002). The least squares mean TLV ratio was 98.2% (95% CI, 88.4%-108.0%) at 6 years before dialysis initiation and 95.7% (95% CI, 85.2%-106.2%) at 6 years after dialysis initiation (P=.01). Although PD did not have significant effects on changes in TLV (P=.27), the changes in TLV were greater in patients on PD than in those on HD.
Conclusion: The TKV increased until dialysis initiation and generally decreased after dialysis initiation. The TLV continued to increase even after dialysis initiation, however, changes in the TLV significantly decreased after dialysis initiation. The increases in TKV and TLV were greater in patients on PD than in those on HD.
Keywords: ACDK, acquired cystic disease of the kidney; ADPKD, autosomal dominant polycystic kidney disease; ALB, albumin; BMI, body mass index; BP, blood pressure; CI, confidence interval; CT, computed tomography; ESKD, end-stage kidney disease; HD, hemodialysis; HR, heart rate; MRI, magnetic resonance imaging; PD, peritoneal dialysis; PKD, polycystic kidney disease; PLD, polycystic liver disease; TAE, transcatheter arterial embolization; TKV, total kidney volume; TLV, total liver volume; UN, urea nitrogen; eGFR, estimated glomerular filtration rate