Graft Survival in Patients With Polycystic Kidney Disease With Nephrectomy of Native Kidney Pretransplant.

INTRODUCTION: Autosomal-dominant polycystic disease (ADPKD) represents 5%-10% of cases of end-stage renal failure. However, management of these patients in terms of whether or not to perform a transplant and optimal timing remains controversial. The objective of our analysis was to evaluate graft survival in patients with ADPKD in which we conduct pretransplant nephrectomy. METHODS: This retrospective study including renal transplant patients secondary to ADPKD in our hospital between January 2000 and December 2012. Pretransplant native kidney nephrectomy was indicated in cases of need for space or repeated complications (cysts). We compared the initial function and graft survival between groups of transplanted based on whether nephrectomy had been performed or not. RESULTS: Eighty-seven patients underwent a kidney transplant owing to ADPKD; 62% (n = 54) were male, with an average age of 55.22 years. Twenty-seven patients (30%) underwent nephrectomy native kidneys before transplantation. There were no serious postoperative complications. Patients who underwent nephrectomy (group 1) showed values of creatinine of 1.57 and 1.50 mg/dL at 3 and 6 months, respectively. In the no nephrectomy group, these values were 2.03 and 1.83 mg/dL, respectively. Graft survival after the first year was of 98% for group 1 and 95% for group 2. The 5-year implant survival was 95% and 80%, respectively. CONCLUSIONS: Native kidney nephrectomy before transplantation in ADPKD is safe in an experienced center, both in terms of surgery-related morbidity and mortality and graft survival and function.

Carta réplica a la carta al director que hace referencia al artículo «Prevalencia de la litiasis renal en Andalucía: resultados del estudio PreLiRenA» / Reply from authors to the letter to the editor that reference to paper «Prevalence of renal stones in Andalusian population: Results of PreLiRenA study»

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Prevalencia de la litiasis renal en Andalucía: resultados del estudio PreLiRenA / Prevalence of Renal Stones in Andalusian Population: Results of PreLiRenA Study

Introducción: La urolitiasis es una enfermedad con alta tasa de recidiva y gran morbilidad asociada. Se está percibiendo un aumento no bien cuantificado en los últimos años que podría estar relacionado con diversos factores. El objetivo principal fue estimar la magnitud de la urolitiasis en Andalucía y determinar qué factores se hallan asociados. Material y métodos: Realizamos un estudio observacional, transversal. Mediante procedimiento aleatorizado polietápico seleccionamos una muestra de 2.439 sujetos, de 40 a 65 años, residentes en Andalucía. La recogida de datos se realizó mediante encuesta telefónica, interrogando a los sujetos sobre antecedentes de litiasis renal, comorbilidad y características sociodemográficas. Realizamos un análisis estadístico descriptivo, bivariado y multivariado (regresión logística múltiple). Resultados: Fueron encuestados 2.439 sujetos, con una edad media de 51,1 ± 7,61 años-desviación típica (intervalo de confianza al 95% [IC 95%]: 50,70-51,30) de los cuales el 48,7% eran varones. La prevalencia de urolitiasis fue del 16,4% (IC 95%:14,87-17,85) y la incidencia del 1,2% (IC 95%: 0,74-1,64). Como variables asociadas a la presencia de urolitiasis en el estudio multivariado encontramos la presencia de antecedentes familiares de litiasis renal (odds ratio [OR]: 1,91; IC 95%:1,51-2,40; p < 0,001); la hipertensión arterial (OR: 1,58; IC 95%: 1,24-2,02; p < 0,001), padecer gota (OR: 1,98; IC 95%: 1,26-3,12; p = 0,003) y un índice de masa corporal elevado (OR: 1,60; IC 95%:1,19-2,17; p = 0,008). Conclusiones: Se constata un incremento importante de la prevalencia e incidencia de urolitiasis en nuestro medio con respecto a las cifras que previamente conocíamos. La presencia de antecedentes familiares de urolitiasis, la hipertensión arterial, la gota, unido a un índice de masa corporal elevado, podrían desempeñar un importante papel en los cambios epidemiológicos observados en la litiasis renal

Introduction: Urolithiasis is a disease having a high recurrence rate and associated morbidity. A not well quantified increase is being seen in recent years that could be related with various factors. The main purpose of our study has been to estimate urolithiasis prevalence and incidence in the region of Andalusia, determining which factors are associated. Material and methods: We performed an observational and cross-sectional study. Using a multistage randomized procedure, we selected a sample of 2439 subjects, aging from 40 to 65 years old, who currently lived in Andalusia. Data was collected through phone interviews, questioning the chosen subjects about their kidney stones history, comorbidity and socio-demographic characteristics. We conducted a descriptive, bivariate and multivariate analysis with logistic regression. esults: A total of 2439 subjects were surveyed. Subjects had mean age of 51.1 ± 7.61 years -standard deviation; (95% confidence interval–95% CI: 50.70-51.30), 48.7% of whom were male. Prevalence of urolithiasis obtained was 16.4% (95% CI: 14.87-17.85%) and an incidence of 1.2 (95% CI: .74-1.64). Variables significantly associated with the presence of urolithiasis found in the multivariate study were: presence of a family history of kidney stones (odds ratio -OR: 1.91; 95% CI: 1.51-2.40, P < .001), hypertension (OR:1.58; 95% CI:1.24-2.02; P < .001), gout (OR:1.98; 95% CI: 1.26-3,12; P = .003) and a high BMI (OR: 1.60; 95% CI 1.19-2.17; p = .008). Conclusions: A significant increase in the prevalence and incidence of urolithiasis is observed in the environment in regards to the previously available figures. The presence of a family history of urolithiasis, hypertension, gout as well as having a high BMI could influence the observed epidemiological changes in renal lithiasis

Prevalence of renal stones in Andalusian population: results of PreLiRenA study.

INTRODUCTION: Urolithiasis is a disease having a high recurrence rate and associated morbidity. A not well quantified increase is being seen in recent years that could be related with various factors. The main purpose of our study has been to estimate urolithiasis prevalence and incidence in the region of Andalusia, determining which factors are associated. MATERIAL AND METHODS: We performed an observational and cross-sectional study. Using a multistage randomized procedure, we selected a sample of 2439 subjects, aging from 40 to 65 years old, who currently lived in Andalusia. Data was collected through phone interviews, questioning the chosen subjects about their kidney stones history, comorbidity and socio-demographic characteristics. We conducted a descriptive, bivariate and multivariate analysis with logistic regression. RESULTS: A total of 2439 subjects were surveyed. Subjects had mean age of 51.1±7.61 years - standard deviation; (95% confidence interval - 95% CI: 50.70-51.30), 48.7% of whom were male. Prevalence of urolithiasis obtained was 16.4% (95% CI: 14.87-17.85%) and an incidence of 1.2 (95% CI: .74-1.64). Variables significantly associated with the presence of urolithiasis found in the multivariate study were: presence of a family history of kidney stones (odds ratio -OR: 1.91; 95% CI: 1.51-2.40, P<.001), hypertension (OR:1.58; 95% CI:1.24-2.02; P<.001), gout (OR:1.98; 95% CI: 1.26-3,12; P=.003) and a high BMI (OR: 1.60; 95% CI 1.19-2.17; p=.008). CONCLUSIONS: A significant increase in the prevalence and incidence of urolithiasis is observed in the environment in regards to the previously available figures. The presence of a family history of urolithiasis, hypertension, gout as well as having a high BMI could influence the observed epidemiological changes in renal lithiasis.