Common Comorbid Conditions Among Patients With ADPKD

Allen Chao and colleagues at the University of California, San Francisco, provide multidisciplinary care to patients with autosomal dominant polycystic kidney disease (ADPKD). During a poster session at the American Society of Nephrology Kidney Week 2023, the team reported on a study evaluating the prevalence of common comorbid conditions in that patient population. The poster was titled ADPKD Comorbid Conditions at a PKD-Focused Center.

Using Epic Systems electronic medical records (EMR), the researchers searched clinical data on patients with ADPKD who were treated in the center’s health system. The analysis included International Classification of Diseases, Tenth Revision codes for hypertension, flank pain, hematuria, pancreatic cysts, hernia, brain aneurysm, nephrolithiasis, liver cysts, urinary tract infection (UTI), liver transplant, and family history of polycystic kidney disease. Data on a subset of patients was validated using chart review.

Of 3561 nephrology visits at the center since 2011, 556 unique patients were identified. Median age of the cohort was 48 years, 54.1% (n=301) were female, 54.3% (n=302) identified as White, 7.6% (n=42) identified as Black, 17.1% (n=95) identified as Asian, 11.2% (n=62) identified as LatinX, the remainder as other race categories.

Mean systolic blood pressure measured at office visits was 133 mm Hg and mean diastolic blood pressure was 77 mm Hg. Median estimated glomerular filtration rate was 60.0 mL/min/1.73 m², and median urine albumin to creatinine ratio was 19.5 mg/g. Sixty-three patients had received a kidney transplant.

Brain aneurysm was inaccurately coded due to automatic generation of a diagnosis of cerebral aneurysm when ordering magnetic resonance angiography at the center. After chart review, only 22 of 74 patients with screening had a true positive brain aneurysm.

The most common comorbidities were hypertension (n=484), flank pain (n=193), liver cysts (n=176), nephrolithiasis (n=111), UTIU (n=99), hematuria (n=79), brain aneurysm (n=22), hernia (n=20), pancreatic cysts (n=14), and liver transplant (n=14).

In summary, the authors said, “EMR data can identify ADPKD patients for both coordinated care and research purposes. Further efforts to quality control true positive cerebral aneurysm coding at our center are needed.”

Source: Chao A, Etwaru D, Park M. ADPKD comorbid conditions at a PKD-focused center. SA-PO749. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2023; November 4, 2023; Philadelphia, Pennsylvania.