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Kidney Week

Abstract: PO1582

Mortality Risk in Elderly ESRD Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD): Study Findings Using Data from the United States Renal Data System

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Authors

  • Mader, Gregory, RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States
  • Mladsi, Deirdre M., RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States
  • Zhou, Xiaolei, RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States
  • Sanon, Myrlene, Otsuka America Pharmaceutical Inc, Rockville, Maryland, United States
  • Wang, Jinyi, RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States
  • Willey, Cynthia J., University of Rhode Island, Kingston, Rhode Island, United States
  • Seliger, Stephen L., University of Maryland School of Medicine, Baltimore, Maryland, United States
Background

Mortality rates may be different for patients in end-stage renal disease (ESRD) with ADPKD compared with patients with other etiologies of ESRD. While mortality estimates have been published by USRDS (2018) for elderly ESRD patients in general (220 per 1,000 patient-years using data from 2012) little has been published reporting national estimates for patients with ADPKD specifically. This analysis sought to estimate ADPKD-specific mortality rates among ESRD patients aged 65 years or older.

Methods

ESRD patients treated with dialysis or transplant with at least one ADPKD diagnosis code and a reported ESRD service date from January 1, 2014, to December 31, 2016, in the US Renal Data System (USRDS) were included. Mortality rates were estimated overall, by sex, by race, and by age group (with a patient’s follow-up potentially spanning two age groups). Both unadjusted mortality and adjusted mortality by 2016 US population age distributions for 65 years and older were estimated.

Results

Of 3,208,884 ESRD patients in the USRDS database, 76,428 patients (2.4%) had ADPKD and of those 14,756 were aged 65 years and older in the study period. Among elderly ADPKD patients, mean age was 70.8 years and overall mortality was 99.8 per 1,000 patient-years (129.6 age-adjusted).

Conclusion

These findings fill an important gap in the literature on ADPKD mortality in the US.

Mortality (Deaths per 1,000 Patient-Years) Among Elderly Patients with ADPKD in ESRD
PopulationNumber of Patients (%)*Mortality (95% CI)Age-adjusted Mortality
Overall14,756 (100%)99.8 (96.4, 103.3)129.6
Overall, by sex7,433 (50.4%)  
Male7,323 (49.6%)104.4 (99.5, 109.6)134.4
Female11,413 (77.3%)95.3 (90.6, 100.2)124.8
Overall, by race   
White11,413 (77.3%)101.7 (97.8, 105.8)136.1
Black1,610 (10.9%)104.7 (94.2, 116.0)123.3
Hispanic1,186 (8.0%)80.0 (69.6, 91.5)100.3
Asian422 (2.9%)91.4 (73.1, 112.9)102.9
Other or unknown125 (0.8%)86.1 (55.1, 128.1)94.2
Overall, by age group   
65 to 74 years11,183 (75.8%)68.8 (65.5, 72.2) 
75 to 84 years3,060 (20.7%)158.9 (150.1, 168.2) 
85 years and older513 (3.5%)340.6 (307.6, 376.2) 

*Patient demographics at study entry.

Funding

  • Commercial Support