Kidney Week

Abstract: TH-PO486

Death-Specific Risk Factors among US Veterans with Autosomal Dominant Polycystic Kidney Disease

Session Information

• Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Mrug, Michal, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Michal Mrug, MD

• Gallini, Julia W., Veterans Health Administration, Washington, District of Columbia, United States

Julia W. Gallini, MS

• Jasien, Christine Lynn, Veterans Health Administration, Washington, District of Columbia, United States

Christine Lynn Jasien

• Chumley, Phillip H., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Phillip H. Chumley

• Cui, Xiangqin, Emory University, Atlanta, Georgia, United States

Xiangqin Cui, PhD

Background

Identifying and addressing death-specific risk factors in people with autosomal dominant polycystic kidney disease (ADPKD) is critical for improving healthcare outcomes and reducing mortality in this patient population.

Methods

To identify death-specific risk factors for ADPKD, we used a cohort of 12,217 ADPKD patients that we recently established using nationwide VA electronic health record data from 1999-2020. Of these patients, 5,342 were identified as deceased based on the VA death index. We used these data to conduct a survival analysis on the time to death from the first use of ADPKD diagnosis ICD codes in the VA database on the whole cohort.

Results

The multivariable Cox regression analysis yielded the following key findings:
1) A higher hazard for death was associated with older age at diagnosis (hazard ratio [HR] per year 1.056; p<0.001) and a longer delay in the ADPKD diagnosis after the initial encounter (HR per year 1.012; p=0.002).
2) A lower hazard of death was associated with a higher estimated glomerular filtration rate (eGFR) at the time of ADPKD diagnosis (HR 0.981; p<0.001) and female gender (HR 0.733; p=0.001).

Conclusion

While some of the identified death-specific risk factors cannot be modified, others, especially the delay in the ADPKD diagnosis after the initial encounter, are potentially modifiable. Together, these findings suggest that interventions leading to earlier ADPKD diagnosis may delay death in patients with ADPKD. However, it is important to note that this study was conducted on a predominantly male population of US veterans, limiting the generalizability of the results.

Funding

• Veterans Affairs Support – Otsuka