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- Title
The impact of pre-transplantation nephrectomy on quality of life in patients with autosomal dominant polycystic kidney disease.
- Authors
Geertsema, Paul; Gansevoort, Ron T.; Brenkman, Lisanne P. J.; Dekker, Shosha E. I.; Eleveld, Damia V. P.; de Fijter, Johan W.; Leliveld, Anna M.; Levy, Maya; Meijer, Esther; Pol, Robert A.; Schillern, Emmelien E. M.; Sanders, Jan-Stephan F.; Casteleijn, Niek F.
- Abstract
Purpose: In selected ADPKD patients, a nephrectomy is required in the work-up for a kidney transplantation. Because the impact of this procedure is unknown, we investigated the effect of pre-transplantation nephrectomy on quality of life in this group. Methods: In this retrospective cohort study all ADPKD patients, ≥ 18 years, who received a kidney transplantation in 2 ADPKD expertise centers between January 2000 and January 2016, were asked to participate. Quality of life was assessed using three validated questionnaires on three time points. Nephrectomy was performed in preparation for transplantation. Results: Two hundred seventy-six ADPKD patients (53 ± 9 years, 56.2% male) were included. 98 patients (35.5%) underwent native nephrectomy in preparation for transplantation, of which 43 underwent bilateral nephrectomy. Pre-transplantation, ADPKD-IS scores were worse in the nephrectomy group vs. no-nephrectomy group (physical: 2.9 vs. 2.3, p < 0.001; emotional: 2.0 vs. 1.8, p = 0.03; fatigue: 3.0 vs. 2.3, p = 0.01). Post-transplantation and post-nephrectomy, ADPKD-IS scores improved significantly in both groups, with a significantly higher improvement in the nephrectomy group. During follow-up, all scores were still better compared to pre-transplantation. Observed physical QoL (ADPKD-IS physical 1.3 vs. 1.7, p = 0.04; SF-36 physical 50.0 vs. 41.3, p = 0.03) was better post-transplantation after bilateral nephrectomy compared to unilateral nephrectomy. In retrospect, 19.7% of patients would have liked to undergo a nephrectomy, while the decision not to perform nephrectomy was made by the treating physician. Conclusion: This study shows that pre-transplantation nephrectomy improves quality of life in selected ADPKD patients. Bilateral nephrectomy may be preferred, although the risk of additional complications should be weighted.
- Subjects
POLYCYSTIC kidney disease; KIDNEY transplantation; NEPHRECTOMY
- Publication
World Journal of Urology, 2023, Vol 41, Issue 4, p1193
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-023-04349-4