ADPKD Death Rates Differ by Race, Ethnicity

Age-adjusted mortality was greatest among Black patients without kidney failure and White patients with kidney failure.

Researchers have identified racial differences in mortality rates among older patients with autosomal dominant polycystic kidney disease (ADPKD), according to study findings presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings.

Using 201-2016 data from the US Renal Data System, Greg Mader, PhD, of RTI Health Solutions in Research Triangle Park, North Carolina, and colleagues calculated mortality rates for patients aged 65 years and older with ADPKD, including 1551 without kidney failure (mean age 76.5), and 14,756 with kidney failure (mean age 70.8 years). In the cohort without kidney failure, age-adjusted mortality was 61.9 per 1000 patient-years overall. Black patients had the highest age-adjusted mortality rate at 82.7 per 1000 patient-years, whereas White, Hispanic, Asian, and other race patients all had rates below the mean at 59.5, 41.4, 51.2, and 54.2 per 1000 patient-years, respectively.

In the cohort with end-stage kidney disease, the overall age-adjusted mortality rate was high at 129.6 per 1000 patient-years. This time White patients had the highest death rate — 136.1 per 1000 patient-years — whereas Black, Hispanic, Asian, and patients of other races had rates below the mean at 123.3, 100.3, 102.9, and 94.2 per 1000 patient-years, respectively.

Only among Black men was mortality higher before kidney failure than after, indicating a possible survivorship effect.

“This would occur if black patients with ADPKD were less likely to receive dialysis or transplant and, therefore, were more likely to die prior to initiation of renal replacement therapy, with those black patients surviving to dialysis or transplant being relatively healthier than their white counterparts,” Dr Mader’s team wrote.

Reference

Mader G, Mladsi D, Zhou X, et al. Racial differences in mortality rates among elderly non-ESRD CKD and ESRD patients with autosomal dominant polycystic kidney disease (ADPKD): study findings using data from the USRDS. Presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings, April 6-10, 2021. Poster 312.