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Polycystic kidney disease at end-stage renal disease in the United States: patient characteristics and survival

K.C. Abbott and L.Y. Agodoa

###ENGLISH_ABSTRACT_LINK### ###FREE_ENGLISH_ARTICLE_DOWNLIAD_LINK###

Volume 57 (2002) p. 208 - 214

Abstract

K.C. Abbott and L.Y. Agodoa

¹Nephrology Service, Walter Reed Army Medical Center, Washington, D.C., and Uniformed Services University of the Health Sciences, Bethesda, MD, ²NIDDK, NIH, Bethesda, MD, USA
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.

Original

Sickle cell nephropathy at end-stage renal disease in the United States: patient characteristics and survival

K.C. Abbott, I.O. Hypolite and L.Y. Agodoa

###ENGLISH_ABSTRACT_LINK### ###FREE_ENGLISH_ARTICLE_DOWNLIAD_LINK###

Volume 58 (2002) p. 9 - 15

Abstract

K.C. Abbott¹, I.O. Hypolite² and L.Y. Agodoa³

¹Nephrology Service, Walter Reed Army Medical Center, Washington, DC, Uniformed Services University of the Health Sciences, Bethesda, MD, ²Office of Minority Health Research Coordination, NIDDK, NIH, Bethesda, MD, and ³National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD, USA
Background: The patient characteristics, including age at presentation to end-stage renal disease (ESRD) and mortality associated with sickle cell nephropathy (SCN) have not been characterized for a national sample of patients. Methods: 375,152 patients in the United States Renal Data System were initiated on ESRD therapy between January 1, 1992 and June 30, 1997 and analyzed in an historical cohort study of SCN. Results: Of the study population, 397 (0.11%) had SCN, of whom 93% were African-American. The mean age at presentation to ESRD was 40.68 ± 14.00 years. SCN patients also had an independently increased risk of mortality (hazard ratio 1.52, 95% CI: 1.27 – 1.82) even after adjustment for placement on the renal transplant waiting list, diabetes, hematocrit, creatinine, and body mass index. However, when receipt of renal transplantation was also included in the model, SCN was no longer significant (p = 0.51, HR = 1.10, 95% CI: 0.82 – 1.48). SCN patients were much less likely to be placed on the renal transplant waiting list or receive renal transplants in comparison to age and race matched controls, and results of survival analysis were similar in this model. Conclusions: SCN patients were much less likely to be listed for or receive renal transplantation than other comparable patients with ESRD. SCN patients were at independently increased of mortality compared with other patients with ESRD, including those with diabetes, but this increased risk did not persist when models adjusted for their low rates of renal transplantation.Correspondence to:
K.C. Abbott, LTC, MC; Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA
Email: kevin.abbott@ na.amedd.army.mil

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