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. 2022 Feb 3;7(4):867-875.
doi: 10.1016/j.ekir.2022.01.1062. eCollection 2022 Apr.

Incidence, Risk Factors and Outcomes of Kidney and Liver Cyst Infection in Kidney Transplant Recipient With ADPKD

Charles Ronsin  1 , Anis Chaba  2 , Ondrej Suchanek  3 , Jean-Philippe Coindre  4 , Clarisse Kerleau  5 , Claire Garandeau  1 , Aurélie Houzet  1 , Diego Cantarovich  1 , Jacques Dantal  1 , Gilles Blancho  1   5 , Magali Giral  1   5 , Grégoire Couvrat-Desvergnes  6 , Simon Ville  1   5
Affiliations

Incidence, Risk Factors and Outcomes of Kidney and Liver Cyst Infection in Kidney Transplant Recipient With ADPKD

Charles Ronsin et al. Kidney Int Rep. .

Abstract

Introduction: Cyst infection is a known complication of autosomal dominant polycystic kidney disease (ADPKD). Here, we describe incidence, risk factors, clinical presentation, and outcomes of cyst infection in kidney transplant recipient.

Methods: We conducted a single-center retrospective cohort study of patients with ADPKD with renal allografts between January 1, 2009, and October 31, 2020. Cyst infection diagnosis was based on previously described clinical and radiological criteria, using positron emission tomography when available.

Results: A total of 296 patients with ADPKD with renal allografts were included, and 21 patients experienced 22 episodes of cyst infection over a median follow-up of 4 (2-7) years. The cumulative incidence rate was 3% at 1 year, 6 % at 5 years, and 12% at 10 years after transplantation. In multivariate analysis, history of cyst infection before transplantation was the only significant risk factor identified to predict the occurrence of cyst infection after kidney transplantation (hazard ratio [HR] 3.47, 95% CI 1.29-9.31). The clinical presentation at diagnosis of cyst infection included isolated fever in 5 (23%) episodes, acute kidney injury in 12 (55%), and severe sepsis/septic shock in 3 (14%) episodes. Among the 16 (73%) episodes with culture positivity, Escherichia coli was the most common pathogen. There was no difference between early (≤1 year after transplantation) and late (>1 year) cyst infection episodes in terms of clinical presentation and outcomes. Cyst infection was significantly associated with graft loss (HR 3.93, 95% CI 1.21-12.80), but no causal relationship could be established.

Conclusion: Incidence of cyst infection in ADPKD after kidney transplantation is low, history of cyst infection representing the main risk factor.

Keywords: autosomal dominant polycystic kidney disease; cyst infection; incidence; kidney transplantation; risk factors.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Flow chart of patients with ADPKD with kidney allograft according to the presence of cyst infection before the transplantation. ADPKD, autosomal dominant polycystic kidney disease; Cyl, cyst.
Figure 2
Figure 2
Cumulative incidence curve of cyst infection of patients with ADPKD and functional kidney allografts. ADPKD, autosomal dominant polycystic kidney disease.
See this image and copyright information in PMC

References

    1. Ryu H., Park H.C., Oh Y.K., et al. RAPID-ADPKD (Retrospective epidemiological study of Asia-Pacific patients with rapId Disease progression of Autosomal Dominant Polycystic Kidney Disease): study protocol for a multinational, retrospective cohort study. BMJ Open. 2020;10 doi: 10.1136/bmjopen-2019-034103. - DOI - PMC - PubMed
    1. Noël N., Rieu P. Pathophysiologie, épidémiologie, présentation clinique, diagnostic et options thérapeutiques dans la polykystose rénale autosomique dominante [Pathophysiology, epidemiology, clinical presentation, diagnosis and treatment options for autosomal dominant polycystic kidney disease] Nephrol Ther. 2015;11:213–225. doi: 10.1016/j.nephro.2015.04.001. - DOI - PubMed
    1. Alam A., Perrone R.D. Management of ESRD in patients with autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis. 2010;17:164–172. doi: 10.1053/j.ackd.2009.12.006. - DOI - PubMed
    1. Spithoven E.M., Kramer A., Meijer E., et al. Analysis of data from the ERA-EDTA Registry indicates that conventional treatments for chronic kidney disease do not reduce the need for renal replacement therapy in autosomal dominant polycystic kidney disease. Kidney Int. 2014;86:1244–1252. doi: 10.1038/ki.2014.120. - DOI - PubMed
    1. Torres V.E., Chapman A.B., Devuyst O., et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med. 2012;367:2407–2418. doi: 10.1056/NEJMoa1205511. - DOI - PMC - PubMed

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