Outcome Comparisons Between Patients on Peritoneal Dialysis With and Without Polycystic Kidney Disease: A Nationwide Matched Cohort Study

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Abstract

Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease. The complications associated with this disease may affect the performance of peritoneal dialysis (PD). The aim of this study was to compare the outcomes between patients on PD with PCKD and without PCKD.

We extracted an incident cohort of adult (≥20 years old) patients on long-term PD from the Taiwan National Health Insurance Research Database. Patients with PCKD were identified by specific diagnosis codes. We recorded baseline comorbidities, socioeconomic status, timing of referral to a nephrologist, prior hemodialysis history before PD, and the type of PD modalities. We compared the risk of death, technique failure, peritonitis, hospitalization, and outpatient visiting as well as overall medical expenditure between the patients with PCKD and a groups of patients without PCKD who were propensity-score matched (1:3). The analysis was carried out by various Cox regression models that considered competing risk and time-varying coefficients.

We enrolled 139 patients with PCKD and 7739 patients without PCKD who started long-term PD between 1999 and 2010. Patients with PCKD were less comorbid and more often treated with automated PD. In the propensity-score matched analysis, both overall survival and technique survival did not differ between the patients and the result was similar for hospitalization and peritonitis after adjusting for the application of automated PD. Furthermore, the overall annual medical expenditures were similar between the patients with and without PCKD.

PD patients with PCKD are comparable to PD patients without PCKD in terms of risk of death, peritonitis, technique failure, and hospitalization in the present study. Furthermore, the medical expenses of the 2 groups after initiation of PD are also indistinguishable.

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