Kidney Disease Cause Predicts ESRD Risk

Cystic kidney disease is associated with a greatest likelihood of progressing to ESRD.
Cystic kidney disease is associated with a greatest likelihood of progressing to ESRD.

Patients with cystic kidney disease are significantly more likely to progress to end-stage renal disease (ESRD) and less likely to die than patients with other primary kidney diseases, a study found.

The study, published online ahead of print in the American Journal of Kidney Diseases, included 6,245 non-dialysis participants in the Study of Heart and Renal Protection (SHARP). Investigators led by Martin J. Landray, PhD, FRCP, of the University of Oxford in the U.K. categorized patients into four groups according to the baseline cause of kidney disease: cystic kidney disease, diabetic nephropathy, glomerulonephritis, and other recorded diagnoses.

During an average 4.7 years of follow-up, 2,080 patients progressed to ESRD: 454 with cystic kidney disease (23% per year); 378 with glomerulonephritis (10% per year); 309 with diabetic nephropathy (12% per year); and 939 with other recorded diagnoses (8% per year). Compared with patients who had cystic kidney disease, those with glomerulonephritis, diabetic nephropathy, and other recorded diagnoses had a 72%, 60%, and 71% decreased risk of ESRD after adjusting for confounding factors.

Patients with cystic kidney disease had the lowest risk of death before ESRD compared with those who had glomerulonephritis, diabetic nephropathy, and other recorded diagnoses (1% vs. 3%, 8%, and 4%, respectively). Patients with diabetic nephropathy had a 2.35 times increased risk of death compared with patients who had cystic kidney disease.

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