scholarly journals Combined renin-angiotensin-aldosterone system blockade and statin therapy effectively reduces the risk of cerebrovascular accident in autosomal dominant polycystic kidney disease: a nationwide population-based cohort study

Oncotarget ◽  
2017 ◽  
Vol 8 (37) ◽  
pp. 61570-61582 ◽  
Author(s):  
Pei-Hsun Sung ◽  
Hsin-Ju Chiang ◽  
Mel S. Lee ◽  
John Y. Chiang ◽  
Hon-Kan Yip ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Statin Therapy ◽  
Polycystic Kidney Disease ◽  
Cerebrovascular Accident ◽  
Autosomal Dominant ◽  
Population Based ◽  
Polycystic Kidney ◽  
Renin Angiotensin Aldosterone System ◽  
Autosomal Dominant Polycystic Kidney

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.

Sign in / Sign up

Export Citation Format

Share Document