Identification of the Factors Associated With Intraperitoneal Pressure in ADPKD Patients Treated With Peritoneal Dialysis

Mickael Sigogne; Lukshe Kanagaratnam; Caroline Mora; Malika Pierre; Andreea Petrache; Claude Marcus; Michel Fischbach; Moustapha Dramé; Fatouma Touré

doi:10.1016/j.ekir.2020.04.012

Identification of the Factors Associated With Intraperitoneal Pressure in ADPKD Patients Treated With Peritoneal Dialysis

Kidney Int Rep. 2020 Apr 29;5(7):1007-1013. doi: 10.1016/j.ekir.2020.04.012. eCollection 2020 Jul.

Authors

Mickael Sigogne^{1

2

3}, Lukshe Kanagaratnam⁴, Caroline Mora¹, Malika Pierre¹, Andreea Petrache¹, Claude Marcus¹, Michel Fischbach⁵, Moustapha Dramé², Fatouma Touré^{1

6}

Affiliations

¹ Division of Nephrology, University Hospital of Reims, Reims, France.
² Division of Nephrology, University Hospital of Angers, Angers, France.
³ Division of Nephrology, Hospital of Le Mans, Le Mans, France.
⁴ Clinical Investigation Center, University Hospital of Reims, Reims, France.
⁵ Division of Nephrology, University Hospital of Strasbourg, Strasbourg, France.
⁶ Nephrology Laboratory, Unit 7369, Matrice Extracellulaire et Dynamique Cellulaire, MEDyC, Reims Champagne Ardenne University, Reims, France.

Abstract

Introduction: Peritoneal dialysis (PD) is reported to be underused in the autosomal dominant polycystic kidney disease (ADPKD) population because doctors fear technical failure caused by reduced abdominal space and high intraperitoneal pressure (IPP).

Methods: We designed a multicenter retrospective study to be carried out in 15 French centers recruiting 60 patients with ADPKD treated with PD to identify factors associated with IPP. Inclusion criteria were start of PD between 2010 and 2017, available tomodensitometry, and IPP measurement in the first year of dialysis. The clinical and radiological data for each patient were reviewed by the same operator. Total kidney volume (TKV), liver volume, and the volume of the abdominal cavity were measured using contouring.

Results: TKV and the volume of the abdominal cavity in women and men were, respectively, 2397 ml versus 3758 ml and 9402 ml versus 12,920 ml. In the univariate analysis, IPP was significantly and positively associated with body surface area (P = 0.0024), body mass index (BMI) (P < 0.0001), the volume of the abdominal cavity (P = 0.0005), and the volume of the dialysate infused in the peritoneal cavity (IPV) (P = 0.0108). In the multivariate analysis, only BMI was still significantly associated with IPP (P = 0.0004).

Conclusions: Our results identified BMI as the main factor linked to IPP in patients with ADPKD. Despite a reliable assessment of the volume of their organs we did not find any correlation between liver and kidney volumes and IPP. To our knowledge, this is the first study designed to identify factors associated with IPP in patients with ADPKD on PD.

Keywords: ADPKD; intraperitoneal pressure; peritoneal dialysis.