Nephrectomy in autosomal dominant polycystic kidney disease : A consensus statement of the ERA Genes & Kidney Working Group
Geertsema, P. (University of Groningen)
Gansevoort, R.T. (University of Groningen)
Arici, M. (Hacettepe University)
Capasso, G. (Biogem Institute of Molecular Biology and Genetics)
Cornec-Le Gall, Emilie (Centre de References Maladies Renales Hereditaires de l'Adulte et de l'Enfant MARHEA)
Furlano, Monica (Institut de Recerca Sant Pau)
Fuster, D.G. (University of Bern)
Galletti, F. (PKD International)
Gómez Dos Santos, V. (Hospital Universitario Ramón y Cajal (Madrid))
Pérez-Gómez, Maria Vanessa (IIS-Fundacion Jimenez Diaz UAM)
Goumenos, D. (University Hospital of Patras)
Halbritter, J. (Charité Universitätsmedizin Berlin)
Jambon, E. (Pellegrin University Hospital)
Korst, U. (PKD International)
Leliveld-Kors, A.M. (University of Groningen)
Musquera, Mireia (Hospital Clínic i Provincial de Barcelona)
Figueiredo, Andreia (University of Coimbra)
Nijenhuis, T. (Radboud University Medical Centre)
Olsburgh, J. (Guy's & St Thomas' NHS Foundation Trust)
Pol, R.A. (University Medical Center Groningen)
Sayer, John (The Newcastle Upon Tyne Hospitals NHS Foundation Trust)
Stippel, D. (University Hospital Cologne (Colònia, Alemanya))
Torra Balcells, Roser (Institut de Recerca Sant Pau)
Müller, R.U. (Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD))
Casteleijn, N.F. (University of Groningen)
Alam, A.
Bammens, B.
Bartram, M.P.
Birn, H.
Budde, K.
Cakiroglu, F.
Castro-Alonso, Cristina
Chebib, F.T.
Dahl, N.K.
De Almeida, E.
Demoulin, Nathalie
Devuyst, Olivier
Eleftheriadis, T.
Prlic, M.F.
Horie, S.
Idrizi, A.
Iyasere, O.
Janssens, P.
Jouret, F.
Luque, Y.
Mallett, A.
Mousseaux, C.
Mrug, M.
Perrone, R.D.
Reiterova, J.
Robles, N.R.
Rroji, M.
Rudnicki, M.A.
Schmitt, R.
Scolari, F.
Tesar, Vladimir
Topaloglu, R.
Trillini, M.
Weekers, L.
Zakrocka, I.
Spahia, N.
Kawano, H.
Muto, S.
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2025
Resumen:	A substantial number of patients with autosomal dominant polycystic kidney disease (ADPKD) undergo a nephrectomy, especially in workup for a kidney transplantation. Currently, there is no evidence-based algorithm to guide clinicians about which patients should undergo nephrectomy, the optimal timing of this procedure, or the preferred surgical technique. This systematic review-based consensus statement aimed to answer important questions regarding nephrectomy in ADPKD. A literature review was performed and extended to a meta-analysis when possible. For this purpose, PubMed and EMBASE were searched up to May 2024. Fifty-four publications, describing a total of 2391 procedures, were included. In addition, an exploratory questionnaire was sent to urologists, nephrologists, and transplant surgeons. These sources were used to develop practice points about indications, complications, mortality, and timing and technique of nephrectomy. In addition, data on renal embolization as a potential alternative to nephrectomy were explored and summarized. To reach consensus, practice points were defined and improved in three Delphi survey rounds by experts of the European Renal Association Working Group Genes & Kidney and the European Association of Urology Section of Transplantation Urology. A total of 23 practice points/statements were developed, all of which reached consensus. Among others, it was deemed that nephrectomy can be performed successfully for various indications and is an intermediate risk procedure with acceptable mortality and minimal impact on kidney graft function when performed before, in the same session or after transplantation. The complication rate seems to increase when the procedure is performed as an emergency. During the workup for transplantation, patient complaints should be assessed routinely by questionnaires to indicate symptom burden. Deciding on the need for nephrectomy and exploring potential alternatives such as kidney embolization should be a process of shared decision-making, preferably after multidisciplinary consultation.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	ADPKD ; kidney transplantation ; Nephrectomy ; Polycystic kidney disease
Publicado en:	Nephrology Dialysis Transplantation, Vol. 40 Núm. 5 (january 2025) , p. 1032-1054, ISSN 1460-2385

DOI: 10.1093/ndt/gfaf019
PMID: 39848914

23 p, 1.7 MB

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