Renal replacement therapy in ADPKD patients: a 25-year survey based on the Catalan registry

• Published in: BMC nephrology Vol. 14; no. 1; p. 186
• Main Authors: Martínez, Víctor, Comas, Jordi, Arcos, Emma, Díaz, Joan Manel, Muray, Salomé, Cabezuelo, Juan, Ballarín, José, Ars, Elisabet, Torra, Roser
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05-09-2013; BioMed Central
• Subjects: Age Distribution; Care and treatment; Comorbidity; Female; Health Care Surveys; Humans; Hypertension; Hypertension - mortality; Kidney diseases; Kidneys; Longitudinal Studies; Male; Middle Aged; Nephrology; Patient outcomes; Polycystic kidney disease; Polycystic Kidney, Autosomal Dominant - mortality; Polycystic Kidney, Autosomal Dominant - rehabilitation; Prevalence; Registries; Renal Replacement Therapy - mortality; Risk Factors; Sex Distribution; Spain - epidemiology; Survival Rate; Transplantation; Treatment Outcome; Spain
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/1471-2369-14-186

Some 7-10% of patients on replacement renal therapy (RRT) are receiving it because of autosomal dominant polycystic kidney disease (ADPKD). The age at initiation of RRT is expected to increase over time.
Clinical data of 1,586 patients (7.9%) with ADPKD and 18,447 (92.1%) patients with other nephropathies were analysed from 1984 through 2009 (1984-1991, 1992-1999 and 2000-2009).
The age at initiation of RRT remained stable over the three periods in the ADPKD group (56.7 ± 10.9 (mean ± SD) vs 57.5 ± 12.1 vs 57.8 ± 13.3 years), whereas it increased significantly in the non-ADPKD group (from 54.8 ± 16.8 to 63.9 ± 16.3 years, p < 0.001). The ratio of males to females was higher for non-ADPKD than for ADPKD patients (1.6-1.8 vs 1.1-1.2). The prevalence of diabetes was significantly lower in the ADPKD group (6.76% vs 11.89%, p < 0.001), as were most of the co-morbidities studied, with the exception of hypertension. The survival rate of the ADPKD patients on RRT was higher than that of the non-ADPKD patients (p < 0.001).
Over time neither changes in age nor alterations in male to female ratio have occurred among ADPKD patients who have started RRT, probably because of the impact of unmodifiable genetic factors in the absence of a specific treatment.