Incidence and Timing of ESRD from ADPKD Varies by Race

Austin—All races and ethnicities are affected by autosomal dominant polycystic kidney disease (ADPKD). However, despite an expectation that the prevalence of ADPKD would be similar among races, assessments in published literature regarding the incidence and age of end-stage renal disease (ESRD) secondary to ADPKD conflict among black and white patient populations with ADPKD.

Erin L. Murphy, MD, and colleagues conducted a retrospective study to examine incident patients with ESRD secondary to ADPKD for the period 2004 to 2013. Results of the study were reported during a poster session at the NKF 2018 Spring Clinical Meetings in a poster titled ESRD from ADPKD: US Incidence Is Lower but Onset Is Earlier in Non-Hispanic Blacks Compared to Non-Hispanic Whites.

Data from the United States Renal Data System (USRDS) were utilized for the study. Cases of ESRD secondary to ADPKD in the USRDS had the primary cause of ESRD identified as “polycystic kidneys, adult type (dominant) on the End-Stage Renal Disease Medical Evidence Report (form CMS-2728).

Covariates for the current analysis were race (non-Hispanic white or non-Hispanic Black) and age at onset of ESRD. Ages were grouped until a count of >10 patients was reached; age ranged from <40 years to ≥75 years. Population denominators used were yearly USRDS and US Census data.

Among patients who progressed to ESRD, non-Hispanic black patients were less likely than non-Hispanic white patients to develop ESRD secondary to ADPKD (odds ratio [OR, 0.38; 95% confidence interval [CI], 0.36-0.39). Following adjustment for US population differences, the risk of ESRD from ADPKD in non-Hispanic black patients remained lower (OR, 0,94; 95% CI, 0.91-0.96).

More young, non-Hispanic black patients (<40 years of age) had incident ESRD secondary to ADKPD compared with non-Hispanic white patients <40 years of age (9.49% vs 7.68%; difference, 1.81% (95% CI, 0.87%-2.84%; P<.001) for the combined years examined. Age of ESRD onset was lower among non-Hispanic black patients compared with non-Hispanic white patients (54.4 years vs 55.9 years; P<.0001).

“ADPKD incidence in non-Hispanic blacks compared to non-Hispanic whites is similar, thought slightly lower. Blacks progress to ESRD at a younger age and thus may be at a higher risk for early progression to ESRD than previously recognized,” the researchers said.

Source: Murphy EL, Dai F, Droher M, et al. ESRD from ADPKD: US incidence is lower but onset is earlier in non-Hispanic blacks compared to non-Hispanic whites. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.