The following article features coverage from the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings. Click here to read more of Renal and Urology News’ conference coverage.

Patients with autosomal dominant polycystic kidney disease (ADPKD) who live in the southern United States are the most likely to be at risk for rapid progression and chronic kidney disease (CKD) stage 4 or 5, according to data presented at the live virtual 2020 National Kidney Foundation Spring Clinical Meetings.

These differences may be related to higher prevalence of risk factors for CKD progression in the southern United States, such as obesity and hypertension, as well as sociocultural and environmental differences, such as disparities in access to healthcare, Cynthia Willey, PhD, of the University of Rhode Island in Kingston, and colleagues concluded in a poster presentation.


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“Increased awareness of the social and environmental factors that contribute to CKD disparities could lead to a better understanding of how contextual risk factors modify ADPKD progression.”

Using IBM MarketScan administration claims in 2017, the investigators studied 4536 patients who had continuous health plan enrollment and 2 or more ADPKD diagnoses. Of these, 1702 37.5% were at risk of rapid progression because they had hypertension by age 35, albuminuria, hematuria, CKD stage 2 by age 30, CKD stage 3 by age 50, or CKD stage 4/5 or a kidney transplant by age 55.

The proportion of patients at risk of rapid progression was highest in the South (42.1%) and lowest in the West (31.6%). The proportion of patients with CKD stage 4/5 or who had a kidney transplant by age 55 ranged from 13.1% in the West and Northeast to 18.2% in the South. The proportion of patients on dialysis ranged from 7.1% in the West to 11.0% in the South. The proportion of obese patients ranged from 10.6% in the West to 15% in the South.

Patients at risk of rapid progression were on average younger than the rest of the study sample (41.6 vs 48.1 years) and less likely to be female (49.8% vs 54.3%).

Read more of our coverage of the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings by visiting the conference page.

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Reference

Willey C, Gauthier-Loiselle M, Cloutier M, et al. Regional variation in severity of autosomal dominant polycystic kidney (ADPKD) in the United States. Data presented at the live virtual 2020 National Kidney Foundation Spring Clinical Meetings held March 25 to 28. ePoster 385.