Abstract: PO1258
Polycystic Kidney Disease and Race
Session Information
- Cystic Kidney Disease - II
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1001 Genetic Diseases of the Kidneys: Cystic
Authors
- Hayward, Alexandra, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Saunders, Milda Renne, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Chapman, Arlene B., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
Background
Racial/ethnic differences in the development of kidney failure (ESKD) and transplant (TX) access are well-documented. ESKD is anticipated in familial autosomal dominant polycystic kidney disease (ADPKD), providing the opportunity for greater ESKD preparation. We sought to define the impact of race on ESKD/TX outcomes in ADPKD.
Methods
White (W), African-American (A), or Hispanic (H) ADPKD patients were identified in USRDS 1/2000-6/2018; demographic and laboratory data were obtained. Median income was derived from US Census. Models included: age at ESKD (linear), pre-emptive TX (logistic), and TX after dialysis initiation (Cox), adjusted for age, sex, albumin, hemoglobin, eGFR, insurance, income, ESKD Network, and employment, with W as referent.
Results
Among 41,485 patients, (77.3% W, 13.3% A, 9.4% H), characteristics/outcomes are shown in Table 1. AA and H had lower median income and less private insurance, pre-ESKD nephrology care, and employment. For AA and H, peritoneal dialysis and TX were less common than in W. Albumin, hemoglobin, and GFR were lowest in A.
ESKD occurred 2.2 ± 0.2 and 4.8 ± 0.3 years earlier in A and H, compared to W. Adjusted odds of pre-emptive TX were 0.38(0.33, 0.42) and 0.47(0.40, 0.55) for A and H. Adjusted hazards for TX after dialysis initiation were 0.60(0.55, 0.65) for A and 0.78(0.72, 0.85, for H, P<0.001 for all. TX rates for A vs W by network are shown in Figure 1.
Conclusion
Despite the hereditary nature of ADPKD, renal outcomes differ by race, attributed to in part, economic and geographic factors. Health inequity is a contributing factor to patient outcomes in ADPKD that needs to be addressed.