Baseline characteristics of the autosomal‐dominant polycystic kidney disease sub‐cohort of the KoreaN cohort study for outcomes in patients with chronic kidney disease

Nephrology ◽  
2019 ◽  
Vol 24 (4) ◽  
pp. 422-429 ◽  
Author(s):  
Hyunsuk Kim ◽  
Junga Koh ◽  
Sue K Park ◽  
Kook H Oh ◽  
Yeong H Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
Baseline Characteristics ◽  
Autosomal Dominant Polycystic Kidney

scholarly journals P0037POPULATION CHARACTERISTICS ACROSS AN EXPANDED POOLED DATABASE OF MULTIPLE AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE CLINICAL STUDIES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Xiaolei Zhou ◽  
Eric Davenport ◽  
John Ouyang ◽  
Molly Hoke ◽  
Diana Garbinsky ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Progression ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Extension Study ◽  
Polycystic Kidney ◽  
History Of ◽  
Baseline Characteristics ◽  
Autosomal Dominant Polycystic Kidney

Abstract Background and Aims Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and the fourth-leading cause of kidney failure. Over the past two decades, various studies have been conducted to characterize the natural history of ADPKD and investigate impacts of potential treatments on disease progression. Previously, we created a pooled longitudinal database of unique subjects from nine studies to evaluate and analyze outcomes. The database was expanded to include data from two recent tolvaptan (TOL) trials (156-13-210 and 156-13-211). Here, we describe the baseline characteristics of the expanded pooled population. Method Data from 11 ADPKD studies (from 2001 to 2018, sponsored by Otsuka or National Institutes of Health) were combined and divided into two groups: TOL and standard of care (SOC). TOL consisted of trial subjects initiating treatment in one of seven trials (156-04-250, 156-04-251, 156-06-260, 156-09-284, 156-09-290, 156-08-271, and 156-13-210); SOC included subjects from placebo arms of two TOL randomized trials (156-04-251 and 156-09-290), all standard blood pressure control arms in the HALT-PKD trials, and subjects from two observational studies (156-10-291 and CRISP). Subjects in the placebo arm of study 156-13-210 received TOL for 5 weeks before randomization and were therefore included in the TOL group. Eligible subjects who completed an early TOL study continued TOL treatment in the extension study 156-08-271 and/or in a second extension study 156-13-211. Estimated glomerular filtration rate (eGFR) was calculated in all studies using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Total kidney volume (TKV) was measured by magnetic resonance imaging and available in all studies except 156-13-210, 156-13-211, and HALT-PKD study B. Results The pooled analysis included 7,117 eligible subjects (TOL: 2,928; SOC: 4,189) from the United States (47.5%) and other countries. The two cohorts had similar age (mean age, 43.6 vs. 44.1 years) and sex distribution (50.5% male vs. 45.2% male). The TOL group had more white subjects (90.5% vs. 80.7%) and fewer Hispanic subjects (4.0% vs. 12.6%), a lower baseline mean eGFR (60 vs. 70 mL/min/1.73 m2), more in chronic kidney disease (CKD) stage 3 or above (58.1% vs. 41.0%), and more frequent history of signs of rapid disease progression (e.g., nephrolithiasis, hematuria, urinary tract infection). Among 4,917 subjects with TKV assessments, mean baseline TKV was higher in the TOL group (1,817 mL) compared with SOC (1,627 mL). Conclusion In this large, longitudinal database of unique subjects with ADPKD, distinct differences exist in some baseline characteristics of the TOL and SOC groups. Compared with the previous database, the expanded database doubled the size of the TOL group and included more subjects who were older and with advanced chronic kidney disease stage. This database provides a diverse ADPKD population to assess outcomes.

scholarly journals Risk of Hospital Encounters With Kidney Stones in Autosomal Dominant Polycystic Kidney Disease: A Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110002
Author(s):  
Vinusha Kalatharan ◽  
Blayne Welk ◽  
Danielle M. Nash ◽  
Stephanie N. Dixon ◽  
Justin Slater ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Kidney Stones ◽  
Autosomal Dominant ◽  
Significant Risk ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney

Background: There is a perception that patients with autosomal dominant polycystic kidney disease (ADPKD) are more likely to develop kidney stones than the general population. Objective: To compare the rate of hospital encounter with kidney stones and the rate of stone interventions between patients with and without ADPKD. Design: Retrospective cohort study. Setting: Ontario, Canada. Patients: Patients with and without ADPKD who had a prior hospital encounter between 2002 and 2016. Measurements: Rate of hospital encounter with kidney stones and rate of stone intervention. Methods: We used inverse probability exposure weighting based on propensity scores to balance baseline indicators of health between patients with and without ADPKD. We followed each patient until death, emigration, outcomes, or March 31, 2017. We used a Cox proportional hazards model to compare event rates between the two groups. Results: Patients with ADPKD were at higher risk of hospital encounter with stones compared with patients without ADPKD (81 patients of 2094 with ADPKD [3.8%] vs 60 patients of 1902 without ADPKD [3.2%]; 8.9 vs 5.1 events per 1000 person-years; hazard ratio 1.6 [95% CI, 1.3-2.1]). ADPKD was not associated with a higher risk of stone intervention (49 of 2094 [2.3%] vs 47 of 1902 [2.4%]; 5.3 vs 3.9 events per 1000 person-years; hazard ratio 1.2 [95% CI = 0.9-1.3]). Limitations: We did not have information on kidney stone events outside of the hospital. There is a possibility of residual confounding. Conclusion: ADPKD was a significant risk factor for hospital encounters with kidney stones.

scholarly journals Primary prevention of cardiovascular disease events with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients with autosomal dominant polycystic kidney disease on dialysis—a nationwide cohort study

2019 ◽  
Author(s):  
Chien-Yu Lin ◽  
Chien-Lin Lu ◽  
Lian-Yu Lin ◽  
Pau-Chung Chen ◽  
Kuo-Cheng Lu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney

Abstract Background: Although renin-angiotensin-aldosterone system (RAAS) blockade has been shown to reduce cardiovascular disease (CVD) in the general population and high risk subjects, their protective effect in autosomal dominant polycystic kidney disease (ADPKD) patients under dialysis was still unknown. Methods: By using the database from 1995 to 2008 Taiwan National Health Insurance Research Database (Registry for Catastrophic Illnesses), we included 387 ADPKD patients who received dialysis therapy, aged ≥18 year-old, and with no evidence of CVD events in 1997 and 1998. We utilized Cox proportional hazards regression analysis and propensity score matching to evaluate adjusted hazard ratios for all-cause mortality and CVD events in users (n=231) and nonusers (n=156) of an angiotensin-converting enzymes inhibitor (ACEI) / angiotensin II receptor blocker (ARB) during the 12 years of follow-up. Results: All study subjects were followed up for more than 3 months. Compared with the control group, the ACEI/ARB treatment group did not have favorable outcome including acute coronary syndromes, receiving coronary intervention, cerebral vascular events, peripheral artery disease, heart failure and overall mortality. The results remain similar between groups before and after propensity score matching. Moreover, there was no significant difference in outcomes between ACEI/ARB treatment over 50% of follow-up period and without ACEI/ARB treatment after propensity score matching. Conclusions: We found ACEI or ARB usage is not associated with a reduction of cardiovascular events and survival benefit in our nationwide cohort study of ADPKD patient on dialysis from Taiwan. Further larger scale, multicenter and randomized control trials are warranted to show the causal association.

scholarly journals Complications in Patients With Autosomal Dominant Polycystic Kidney Disease Undergoing Ureteroscopy: A Cohort Study

2020 ◽  
Vol 7 ◽  
pp. 205435812097283
Author(s):  
Vinusha Kalatharan ◽  
Blayne Welk ◽  
Danielle M. Nash ◽  
Eric McArthur ◽  
Justin Slater ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Hospital Admission ◽  
Polycystic Kidney Disease ◽  
Emergency Department Visit ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney

Background: Ureteroscopy is a minimally invasive treatment option for upper tract stones. The distorted kidney anatomy in patients with autosomal dominant polycystic kidney disease (ADPKD) may place them at higher risk for ureteroscopic complications. Objective: To compare the 30-day risk of ureteroscopic complications between patients with and without ADPKD. Design: Retrospective cohort study. Setting: Ontario, Canada Patients: Seventy three patients with ADPKD and 81 445 patients without ADPKD who underwent ureteroscopy for upper urinary tract stones between April 1, 2002, and March 1, 2018. Measurements: A 30-day risk of (1) hospital presentation with ureteroscopic complications (which was a composite outcome of either emergency department visit or hospital admission with acute kidney injury, urinary tract infection, or sepsis); (2) all-cause hospital presentation; (3) all-cause hospital admission; and (4) all-cause emergency department visit. Methods: We regressed outcomes on demographic variables, health care use in the prior 1-year, various procedures and comorbidities related to the outcome in the prior 5 years, and prescribed medications filled in the past 120 days using modified Poisson regression to compare the risk ratio (RR) of each outcome between patients with and without ADPKD. Results: The median (interquartile, IQR) age was 44 (38-60 years) in the ADPKD group and 53 (42-64) in the control group. About 40% were women in both groups. The risk of ureteroscopic complications was not significantly different in patients with versus without ADPKD (8.2% vs 4.3%; adjusted RR = 1.5, 95% confidence interval [CI] = 0.7-3.2). Patients with versus without ADPKD were more likely to present to hospital after their procedure (35.6% vs. 20.0%; adjusted RR = 1.6, 95% CI = 1.2-2.2), which included a statistically significant increase in the risk of presenting to the emergency department (32.9% vs. 19.0%; adjusted RR = 1.6, 95% CI = 1.1-2.2) but not hospital admissions (10.9% vs. 5.0%; adjusted RR = 1.8, 95% CI = 0.9-3.4). Limitations: The low numbers of events led to imprecision around the estimates. Conclusion: Patients with ADPKD have a higher risk of return to the hospital within 30 days of ureteroscopy for stone disease. Trial registration: We did not register this study.

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