The impact of pre-transplantation nephrectomy on quality of life in patients with autosomal dominant polycystic kidney disease

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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.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00345-023-04349-4.

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Author and article information

Contributors

Niek F. Casteleijn: N.F.Casteleijn@umcg.nl

Journal

Journal ID (nlm-ta): World J Urol

Journal ID (iso-abbrev): World J Urol

Title: World Journal of Urology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0724-4983

ISSN (Electronic): 1433-8726

Publication date (Electronic): 17 March 2023

Publication date PMC-release: 17 March 2023

Publication date (Print): 2023

Volume: 41

Issue: 4

Pages: 1193-1203

Affiliations

[1 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Department of Nephrology, , University Medical Center Groningen, University of Groningen, ; Groningen, The Netherlands

[2 ]GRID grid.10419.3d, ISNI 0000000089452978, Department of Nephrology, , Leiden University Medical Center, ; Leiden, The Netherlands

[3 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Department of Urology, Expertise Center for Polycystic Diseases, , University Medical Center Groningen, University of Groningen, ; PO Box 30.001, 9700 RB Groningen, The Netherlands

[4 ]GRID grid.4830.f, ISNI 0000 0004 0407 1981, Department of Surgery, University Medical Center Groningen, , University of Groningen, ; Groningen, The Netherlands

Author information

Paul Geertsema http://orcid.org/0000-0003-1376-9727

Article

Publisher ID: 4349

DOI: 10.1007/s00345-023-04349-4

PMC ID: 10160200

PubMed ID: 36930253

SO-VID: b0a570eb-3f6e-48da-b368-c919566c8083

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 7 October 2022

Date accepted : 25 February 2023

Custom metadata

ScienceOpen disciplines: Urology

Keywords: adpkd,nephrectomy,quality of life,kidney transplantation,polycystic kidney disease

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ScienceOpen disciplines: Urology

Keywords: adpkd, nephrectomy, quality of life, kidney transplantation, polycystic kidney disease

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The impact of pre-transplantation nephrectomy on quality of life in patients with autosomal dominant polycystic kidney disease

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Supplementary Information

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Asian Journal of Quality of Life (AjQoL)

Most cited references 35

Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

The PHQ-9: validity of a brief depression severity measure.

Validating the SF-36 health survey questionnaire: new outcome measure for primary care.

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