Investigators have identified predictors of rapid renal decline among the population with autosomal dominant polycystic kidney disease (ADPKD).
“Using real-world data from routine clinical practice, we found that 6 variables (age, hemoglobin, proteinuria, hypertension, cerebrovascular disease, and sex) highly predicted [rapid renal decline] among patients with ADPKD,” John J. Sim, MD, of Kaiser Permanente Research & Evaluation, Pasadena, California, and colleagues reported in a poster presentation at the National Kidney Foundation’s 2022 Spring Clinical Meetings in Boston, Massachusetts. The investigators generated their models using 42 baseline measurements from clinical practice. Two other variables – mean creatinine and liver disease – proved less predictive and were excluded from the final model. Results from the final model showed 72% sensitivity, 70% specificity, 70% accuracy, and 0.77 area under the curve in identifying rapid renal decline.
For the study, the investigators identified 1744 patients with ADPKD from the 2002-2018 Kaiser Permanente Southern California database, of whom 125 (7%) experienced rapid renal decline according to trajectories of estimated glomerular filtration rate (eGFR). At baseline, the mean eGFR was 85.2 and 72.9 mL/min/1.73 m2 among the group with rapid and non-rapid renal decline, respectively. At 5 years, 38% and 7% of patients with and without rapid renal decline, respectively, progressed to end-stage kidney disease. Among the study’s limitations, genetic and imaging results were not available for all patients.
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“This clinical risk prediction model may serve as a practical screening tool to capture and manage high-risk patients with ADPKD who may need earlier and intensive management strategies,” Dr Sim’s team concluded.
Disclosure: This research was supported by Otsuka Pharmaceuticals. Please see the original reference for a full list of disclosures.
Reference
Sim J, Shu YH, Harrison T, et al. Predictors associated with rapid decline of eGFR to end-stage kidney disease (ESKD) among a diverse autosomal dominant polycystic kidney disease (ADPKD) population. Presented at the National Kidney Foundation 2022 Spring Clinical Meetings, Boston, Massachusetts, April 6-10, 2022. Poster 349.
