P1165PERITONEAL DIALYSIS OR HAEMODIALYSIS FOR POLYCYSTIC KIDNEY DISEASE? TEN YEARS' EXPERIENCE IN A SINGLE CENTRE

Abstract Background and Aims When polycystic kidney disease (PKD) progresses into end-stage renal disease (ESRD), the choice of dialysis modality is often not straight forward. It is believed that PKD may increase risk of complications and technique failure (TF) in peritoneal dialysis (PD) due to enlarged kidneys and/or liver. In this study, we looked at the long-term outcomes of PKD patients put on either PD or haemodialysis (HD). Method New cases of ESRD due to PKD that entered into the dialysis program of United Christian Hospital, Hong Kong from 1st December 2009 to 30th November 2019 were identified. Their baseline demographics, mean kidney size (mean size of right and left kidneys) and clinical outcomes were recorded. Hong Kong has a ‘PD first’ policy. But for PKD patients, the decision to start PD or HD is by the attending nephrologists’ clinical judgment. For the statistical analysis, chi-square test was used for comparison of categorical variables, while t-test was used for continuous variables. Kaplan-Meier curve was used to analyse survival. Results A total of 45 patients were identified. Thirty-one patients were put on PD, while fourteen were put on HD. Their baseline characteristics were shown in Table 1. HD patients had significantly higher mean kidney size to body weight ratio (0.32 ± 0.12 cm/kg) compared to PD patients (0.25 ± 0.08 cm/kg). The median survival between PD patient (7.1 years) and HD patients (7.2 years) was not significantly different. For those PKD patients on PD, the 5-year TF rate was 0.22, which was similar to overall PD patients in our centre. Four patients had early TF (mean time 1.6 years) due to possible PKD related reasons. Two of them had significant pressure symptoms, the other two had inadequate dialysis. Further analysis showed that for those with TF, both the mean kidney size (20.0 ± 5.3 cm) and mean kidney size to body weight ratio (0.32 ± 0.08 cm/kg) were significantly higher than those without TF (15.0 ± 4.1 cm and 0.24 ± 0.07 cm/kg respectively) (Table 2). Conclusion This study showed that for PKD patients with moderate enlarged kidneys, PD could be a reasonable choice. However, for patients with very large kidneys, the early TF rate with PD was high, HD would be a better choice for these patients. Table 1 PD HD p-value Patient number 31 14 Age 54.9 ± 8.5 53.0 ± 10.0 0.513 Gender (male) 45.2% 35.7% 0.553 Diabetes Mellitus 22.6% 0.0% 0.053 Hypertension 54.8% 57.1% 0.885 Previous abdominal surgery 12.9% 14.3% 0