Mortality Risk in ADPKD

The leading hereditary cause of end-stage renal disease (ESRD) is autosomal dominant polycystic kidney disease (ADPKD). However, data regarding mortality specific to patients with ADPKD are limited. So, Deirdre Mladsi, BA, and others conducted a study of mortality in this population using data from the United States Renal Data System.

The researchers analyzed data of 1936 patients with ADPKD and non-ESRD chronic kidney disease (CKD) and 37,461 patients with ADPKD and ESRD. They measured overall mortality rates with 95% CI and calculated mortality rates by age, sex, and race for the total dataset, then again for a subset of patients aged ≥65 years.

Age-adjusted mortality was 18.4 deaths per 1000 patient-years in the non-ESRD CKD group and 37.4 deaths per 1000 patient-years in the ESRD group. In the non-ESRD CKD cohort, patients with CKD stages 4 and 5 had a greater risk of death than patients in stage 3 (hazard ratio [HR], 1.59 for stage 4 and HR, 2.71 for stage 5). Among the ESRD cohort, patients on dialysis were more likely to die than patients who received a transplant (HR, 2.36).

Mortality rates specific to patients aged ≥65 years imply that there are racial differences in mortality among these patients in both the non-ESRD CKD and ESRD cohorts. In the non-ESRD CKD group, age-adjusted mortality for patients aged ≥65 years was highest for Black patients (82.7 deaths per 1000 patient-years), but it was highest for White patients of the same age in the ESRD group (136.1 deaths per 1000 patient-years).

Source: BMC Nephrology