Research Paper Volume 12, Issue 4 pp 3899—3910

Clinical burden of autosomal dominant polycystic kidney disease

Peir-Haur Hung 1, 2, *, , Chien-Hung Lin 3, 4, 5, 6, *, , Kuan-Yu Hung 7, , Chih-Hsin Muo 8, , Mu-Chi Chung 9, , Chao-Hsiang Chang 10, , Chi-Jung Chung 11, 12, ,

  • 1 Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia-Yi, Taiwan
  • 2 Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
  • 3 Division of Pediatric Immunology and Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
  • 4 Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
  • 5 Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
  • 6 College of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan
  • 7 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 8 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  • 9 Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
  • 10 Department of Urology, China Medical University Hospital, Taichung, Taiwan
  • 11 Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
  • 12 Department of Public Health, China Medical University, Taichung, Taiwan
* Equal contribution

received: August 31, 2019 ; accepted: February 8, 2020 ; published: February 24, 2020 ;

https://doi.org/10.18632/aging.102858
How to Cite

Copyright © 2020 Hung et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

There are no specific therapies for autosomal dominant polycystic kidney disease (ADPKD), and clinical data evaluating the effects of non-specific therapies on ADPKD patients are scarce. We therefore evaluated those effects using data from a longitudinal health insurance database collected from 2000-2010. We individually selected patients with and without ADPKD from inpatient data files as well as from the catastrophic illness registry in Taiwan based on 1:5 frequency matching for sex, age, and index year. The hazard ratios (HR) of all-cause mortality, ischemic stroke, hemorrhagic stroke and end-stage renal disease (ESRD) in ADPKD inpatients were elevated as compared to the controls. Similarly, ADPKD patients from the catastrophic illness registry had an increased risk of hemorrhagic stroke and ESRD. Allopurinol users also had an increased risk of all-cause mortality. The HR for developing ESRD after medication exposure was 0.47-fold for statin and 1.93-fold for pentoxifylline. These results reveal that patients with ADPKD (either inpatient or from the catastrophic illness registry) are at elevated risk for hemorrhagic stroke and ESRD, and suggest that allopurinol and pentoxifylline should not be prescribed to ADPKD patients due to possible adverse effects.

Abbreviations

ACEI: angiotensin converting enzyme inhibitor; ADPKD: autosomal dominant polycystic kidney disease; ARB: angiotensin II receptor blocker; CIs: confidence intervals; CKD: chronic kidney disease; ESRD: end-stage renal disease; HR: hazard ratios; LHID-CIP: longitudinal health insurance database for catastrophic illness patients; NHI: National Health Insurance; NHIRD: National Health Insurance Research Database.