Abstract: TH-PO397
Effect of Kidney Transplantation on Total Kidney Volume in Subjects With Autosomal Polycystic Kidney Disease
Session Information
- Genetic Diseases of the Kidneys: Cystic - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1101 Genetic Diseases of the Kidneys: Cystic
Authors
- Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
- Perez, Aaron Horeb, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
- Linares, Estefania Reul, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
- Hernández, Elisa Naomi, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
- Gaytan Arocha, Jorge, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
- Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background
There is limited evidence of the rate of cyst progression after kidney transplantation in patients with Autosomal Polycystic Kidney Disease (APKD).
Methods
Prospective cohort study. The primary objective was to compare the total kidney volume (TKV) before and after transplantation in kidney transplant recipients (KTR) with ADPKD. As a secondary objective, we compared the growth rate of KTR with a cohort of APKD patients who did not undergo transplantation.TKV was assessed with computed tomography/magnetic resonance images performed consecutively. TKV was assessed using ellipsoid equation. TKV growth were classified according to the Mayo Clinic Criteria.
Results
We included 30 patients with APKD who underwent kidney transplant (age 49 ±10.1 years, 11 [37%] females, dialysis vintage 3 [1-6] years, unilateral peritransplant nephrectomy in 4 [13%]). A rapid progression previous transplant (TKV increase >4.5% per year, class 1D and 1E) was identified in 20 (66%) cases. Transplantation was associated with a significant decrease in KTV after transplantation in 27 (90%) KTR. Median TKV reduced from 2964 (IQR 1843-3878) mL to 943 (IQR 383-1598) mL after 6 years of follow-up (P<0.001), with a mean rate of volume decrease of 39% and 63% after 2 and 6 years of transplant respectively (Figure). Compared to the cohort of non-transplanted APKD patients (n=92), the growth rate was similar in KTR (P=0.67). Even in 3 (10%) KTR without regression, the annual growth was <1.5% per year after transplant.
Conclusion
Kidney transplantation reduced rapidly polycystic kidneys volume in the first 2 years after transplantation, and this decline was continuous during the 6 years of follow-up. These data would reduce the need for prophylactic nephrectomy in asymptomatic APKD patients prior to kidney transplantation.