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Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
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Cardiometabolic comorbidities in autosomal dominant polycystic kidney disease: a 16-year retrospective cohort study

Li-Chi Chen1,2, Yi-Chi Chu1, Tzongshi Lu3

  • 1Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 115, Taiwan.

BMC Nephrology
|November 10, 2023
PubMed

Insights

Autosomal-dominant polycystic kidney disease (ADPKD) patients with hypertension, diabetes, and dyslipidemia face a significantly higher risk of end-stage renal disease (ESRD). Managing these cardiometabolic conditions is crucial for improving kidney outcomes and survival in ADPKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Autosomal-dominant polycystic kidney disease (ADPKD) is a leading cause of hereditary kidney disease and end-stage renal disease (ESRD).
  • Limited epidemiological data exists on risk factors and survival for ADPKD patients on renal replacement therapy (RRT).

Purpose of the Study:

  • To investigate the cumulative impact of cardiometabolic comorbidities on clinical outcomes in ADPKD patients.
  • To assess the association between hypertension (HTN), type 2 diabetes mellitus (DM), and dyslipidemia (DLP) and the risk of ESRD and mortality in ADPKD.

Main Methods:

  • A nationwide population-based study identified 6,142 ADPKD patients (aged ≥20 years) from 2000-2015.
  • Cardiometabolic comorbidities (HTN, DM, DLP) diagnosed before or at ADPKD diagnosis were analyzed as predictors.
  • Survival analyses estimated adjusted risks for mortality and renal survival based on comorbidity combinations.

Main Results:

  • ADPKD patients developing ESRD exhibited significantly higher all-cause mortality (HR: 5.14).
  • The presence of all three comorbidities (HTN, DM, DLP) posed the highest risk for entering ESRD (HR: 4.15), followed by combinations including HTN.
  • Hypertension alone also significantly increased ESRD risk (HR: 3.10) compared to no cardiometabolic comorbidities.

Conclusions:

  • A cumulative effect of HTN, DM, and DLP significantly increases the risk of developing ESRD in ADPKD patients.
  • Proactive prevention and management of cardiometabolic comorbidities are essential for improving renal outcomes and overall survival in ADPKD.
  • These findings underscore the importance of integrated care for ADPKD patients, addressing both kidney disease and associated metabolic conditions.
Abstract

Keywords:
ADPKDAll-cause mortalityCardiometabolic comorbiditiesESRDRenal replacement therapy

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