Polycystic kidney disease at end-stage renal disease in the United States: patient characteristics and survival
K.C. Abbott, L.Y. Agodoa
1 Nephrology Service, Walter Reed Army Medical Center, Washington, D.C., and Uniformed Services University of the Health Sciences, Bethesda, MD, 2 NIDDK, NIH, Bethesda, MD, USA
DOI 10.5414/CNP57208
Abstract
Background: The patient
characteristics and mortality associated with autosomal dominant polycystic kidney disease
have not been characterized for a national sample of end-stage renal disease (ESRD)
patients. Methods: 375,152 patients in the United States Renal Data System were
initiated on ESRD therapy (including patients who eventually received renal transplants)
between January 1, 1992 and June 30, 1997 and analyzed in an historical cohort study of
polycystic kidney disease. Results: Of the study population, 5,799 (1.5%) had
polycystic kidney disease. In logistic regression, polycystic kidney disease was
associated with Caucasian race (odds ratio 3.31, 95% CI, 3.09 – 3.54), women (1.10,
1.04 – 1.16), receipt of renal transplant (4.15, 3.87 – 4.45), peritoneal
dialysis (vs. hemodialysis, 1.37, 1.27 – 1.49), younger age, and more recent year of
first treatment for ESRD. Use of pre-dialysis EPO but not the level of serum hemoglobin at
initiation of ESRD was significantly higher in patients with polycystic kidney disease.
Patients with polycystic kidney disease had lower mortality compared to patients with
other causes of ESRD, but patients with polycystic kidney disease had a higher adjusted
risk of mortality associated with hemodialysis (vs. peritoneal dialysis) compared to
patients with other causes of ESRD (hazard ratio 1.40, 1.13 – 1.75). Conclusions:
Hematocrit at presentation to ESRD was not significantly different in patients with
polycystic kidney disease compared with patients with other causes of ESRD. Peritoneal
dialysis is a more frequent modality than hemodialysis in patients with polycystic kidney
disease, and patients with polycystic kidney disease had an adjusted survival benefit
associated with peritoneal dialysis, compared to patients with other causes of renal
disease.
Author Details
Authors
Departments
- 1 Nephrology Service, Walter Reed Army Medical Center, Washington, D.C., and Uniformed Services University of the Health Sciences, Bethesda, MD,
- 2 NIDDK, NIH, Bethesda, MD, USA
Address
Citation
K.C. Abbott and L.Y. Agodoa.Polycystic kidney disease at end-stage renal disease in the United States: patient characteristics and survival. 2002; 57: 208-214. doi: 10.5414/CNP57208.
