Attenuated Antihypertensive Requirements In Autosomal Dominant Polycystic Kidney Patients Undergoing Native Nephrectomy With Renal Transplantation: A Contemporary Analysis

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-06 ATTENUATED ANTIHYPERTENSIVE REQUIREMENTS IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY PATIENTS UNDERGOING NATIVE NEPHRECTOMY WITH RENAL TRANSPLANTATION: A CONTEMPORARY ANALYSIS William Schrock, Hitesh Dube, Jason Farrow, Clinton Bahler, Asif Sharfuddin, William Goggins, and Chandru Sundaram William SchrockWilliam Schrock More articles by this author , Hitesh DubeHitesh Dube More articles by this author , Jason FarrowJason Farrow More articles by this author , Clinton BahlerClinton Bahler More articles by this author , Asif SharfuddinAsif Sharfuddin More articles by this author , William GogginsWilliam Goggins More articles by this author , and Chandru SundaramChandru Sundaram More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Autosomal Polycystic Kidney Disease (ADPKD) contributes to end stage renal disease and multiple extrarenal comorbidities, notably hypertension, with attendant sequelae. While renal transplant alone can improve quality of life, we previously correlated concurrent native nephrectomy with markedly improved blood pressure control. Further improvement was seen following staged bilateral versus unilateral native nephrectomy. This study contemporizes our prior investigation with another half-decade of patients. METHODS: 189 ADPKD patients underwent renal transplant at our institution from 2003 and 2018. Demographics included age, sex, BMI, and Charlson Comorbidity Index (CCI). Retrospectively at pre-transplant, 12-, 24-, and 36-months post-transplant, antihypertensive dosage was standardized by the World Health Organization’s daily defined dose (DDD). Patients received transplant alone, or transplant and concurrent ipsilateral native nephrectomy with or without staged contralateral native nephrectomy. SPSS 27.0 (IBM, Armonk, NY) was used for analyses. RESULTS: With the exception of comorbidities, there were no observed demographic differences between groups (Table 1). On non-parametric analysis at all postoperative follow-up intervals, DDD and total antihypertensives significantly decreased in groups undergoing unilateral and staged nephrectomy but not transplant alone (Fig. 1a-b, p<0.05). No significant difference was noted between unilateral and staged nephrectomy in terms of either DDD or number of antihypertensive prescribed. CONCLUSIONS: Native nephrectomy combined with renal transplant correlates with improved hypertensive control in APDKD patients. Additional long-term follow-up is needed to determine if there is significant added benefit (beyond symptom control) when undergoing staged contralateral native nephrectomy. Source of Funding: Institutional © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e647-e647 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Schrock More articles by this author Hitesh Dube More articles by this author Jason Farrow More articles by this author Clinton Bahler More articles by this author Asif Sharfuddin More articles by this author William Goggins More articles by this author Chandru Sundaram More articles by this author Expand All Advertisement PDF downloadLoading ...