Kidney Week

Abstract: SA-PO749

ADPKD Comorbid Conditions at a PKD-Focused Center

Session Information

• Genetic Diseases: Cystic - Genetic Analysis and Extrarenal Manifestations
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Chao, Allen, University of California San Francisco, San Francisco, California, United States

Allen Chao,

• Gao, Ying, University of California San Francisco, San Francisco, California, United States

Ying Gao,

• Etwaru, Diana, University of California San Francisco, San Francisco, California, United States

Diana Etwaru,

• Park, Meyeon, University of California San Francisco, San Francisco, California, United States

Meyeon Park,

Background

We are a center providing multidisciplinary care to patients with autosomal dominant polycystic kidney disease (ADPKD). We sought to evaluate the prevalence of common co-morbid conditions in our patient population.

Methods

We used the Epic Systems electronic medical record (EMR) at our institution to perform a search for clinical data on patients with ADPKD seen in our health system. We used the following ICD-10 codes: hypertension (I10, I15.1, N28.89), flank pain (R10.9, G89,29), hematuria (R31.0, R31.1, R31.9, R31.2), pancreatic cysts (D49.0, K86.2, Q45.2), hernia (K45.0, K42.9), brain aneurysm (Q28.3, I72.9, I67.1, I71.21, I71.9, I71.4, Z86.79), nephrolithiasis (N20.0), liver cysts (Q44.6, K76.89), urinary tract infection (UTI, N39.0), liver transplant (Z94.4), and family history of PKD (Z84.1). We performed chart review to validate data on a subset of patients.

Results

556 unique patients were identified out of a total of 3561 Nephrology clinic visits at our center since 2011. The median age was 48 years old [IQR 35-62]. 301 patients (54.1%) were women. A majority of patients identified as White (302, 54.3%), 42 (7.6%) Black, 95 (17.1%) Asian, 62 (11.2%) LatinX, and remainder Other race categories. The mean (SD) systolic blood pressure (SBP) obtained from office visit measures was 133.3±17.8 mmHg and mean (SD) diastolic blood pressure (DBP) was 77.0±11.4 mmHg. The median [IQR] estimated glomerular filtration rate (eGFR) was 60.0 [38.5, 93.0] ml/min/1.73m². Median [IQR] urine albumin to creatinine ratio was 19.5 [8.6, 99.7] mg/g. 63 (11%) patients had received a kidney transplant. Co-morbidities are shown in the Figure. We found that brain aneurysm was inaccurately coded due to automatic generation of a diagnosis of cerebral aneurysm when ordering magnetic resonance angiography (MRA) at our center; only 22 out of 74 patients with screening had a true positive brain aneurysm after chart review.

Conclusion

EMR data can identify ADPKD patients for both coordinated care and research purposes. Further efforts to quality control true positive cerebral aneurysm coding at our center are needed.