Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Mortality risk in patients with autosomal dominant polycystic kidney disease,” published in the February 2024 issue of Nephrology by Mladsi et al.
Researchers conducted a retrospective analysis to investigate mortality rates in individuals diagnosed with Autosomal Dominant Polycystic Kidney Disease (ADPKD), the primary inheritable cause of End-Stage Renal Disease (ESRD).
They studied data from the United States Renal Data System (USRDS) for patients with ADPKD (January 1, 2014, to December 31, 2016), involving cohorts of non-end-stage renal disease (non-ESRD) chronic kidney disease (CKD) and ESRD patients. Mortality rates with 95% CIs were calculated for the entire dataset and for a subset of patients aged ≥ 65 years by age group, sex, and race. Adjusted mortality HRs were determined using Cox regression modeling, considering age group, sex, race, and CKD stage (non-ESRD CKD stages 1–5) or ESRD treatment (dialysis and transplant).
The results showed 1,936 patients with ADPKD and non-ESRD CKD, alongside 37,461 patients with ADPKD and ESRD. Age-adjusted mortality was recorded at 18.4 deaths per 1,000 patient-years in the non-ESRD CKD group and 37.4 deaths per 1,000 patient-years in the ESRD cohort. Within the non-ESRD CKD cohort, patients in CKD stages 4 and 5 faced a heightened risk of death compared to those in stage 3 (HR = 1.59 for stage 4 and HR = 2.71 for stage 5). In the ESRD cohort, dialysis patients exhibited a greater likelihood of death than transplant recipients (HR = 2.36). Among patients aged ≥ 65 years, Black patients in the non-ESRD CKD cohort had the highest age-adjusted mortality (82.7 deaths per 1,000 patient-years), while White patients in the ESRD cohort topped the list (136.1 deaths per 1,000 patient-years).
They concluded that analysis of ADPKD patients revealed racial disparities in mortality after age 65, highlighting a crucial gap in US mortality estimates for this population.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03484-3