Clinical studies of polycystic kidney disease (PCK) on maintenance hemodialysis

Objectives: The present study was undertaken to retrospectively evaluate clinical characteristics and other factors possibly affecting the progression of renal failure in patients with polycystic kidney disease (PCK). Subjects and Methods: Twenty six patients (males 10; females 16) with PCK who had been introduced to chronic hemodialysis (HD) between 1975 and 1991 in Jichi Medical School Hospital were analyzed for clinical symptoms and progression of renal failure based on reciprocal serum creatinine values, causes of death and the survival rate. Furthermore, the relationships among the size, number and occupancy rate of cysts and the reciprocal serum creatinine values were examined. Results and conclusion: Hypertension, abdominal mass, hematuria and hepatic cysts were common clinical findings. The slope of the reciprocal serum creatinine values showed a negative correlation with the ages of the patients. This means that the progression of renal failure in older patients is slower than that in younger patients. Therefore, age seems to be one of the major determinants of the progression of renal failure in the patients with PCK. Hematocrit values showed a similar decrease with the progression of renal failure, which is consistent with the other causes of chronic renal failure. Ten out of 26 patients died during the study, among whom 6 died of cerebrovascular diseases. Survival rates at one, five and ten years after commencement of HD therapy were 96.2%, 53.3% and 30.8%, respectively. There were no significant correlations among the occupancy rate of cysts in the kidney, the number of cysts, age, the serum creatinine level, hematocrit values or the slopes of 1/Scr.