Identification of people with autosomal dominant polycystic kidney disease using routine data: a cross sectional study

• Published in: BMC nephrology Vol. 15; no. 1; p. 182
• Main Authors: McGovern, Andrew P, Jones, Simon, van Vlymen, Jeremy, Saggar, Anand K, Sandford, Richard, de Lusignan, Simon
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.11.2014; BioMed Central
• Subjects: Adolescent; Adult; Age Factors; Analysis; Antihypertensive Agents - therapeutic use; Biomarkers - analysis; Care and treatment; Complications and side effects; Cross-Sectional Studies; Diagnosis; Drug Therapy, Combination; Early Diagnosis; England; Female; Hematuria - etiology; Hemoglobin; Humans; Hypertension, Renal - drug therapy; Hypertension, Renal - etiology; Kidney Function Tests; Logistic Models; Male; Mass Screening - methods; Medical screening; Middle Aged; Nephrology; Polycystic kidney disease; Polycystic Kidney, Autosomal Dominant - complications; Polycystic Kidney, Autosomal Dominant - diagnosis; Polycystic Kidney, Autosomal Dominant - urine; Predictive Value of Tests; Primary Health Care; Proteinuria - etiology; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - etiology; Risk Assessment; Risk Factors; Sensitivity and Specificity; Young Adult; England; United Kingdom
• DOI: 10.1186/1471-2369-15-182
• ISSN: 1471-2369

Autosomal dominant polycystic kidney disease (ADPKD) causes progressive renal damage and is a leading cause of end-stage renal failure. With emerging therapies it is important to devise a method for early detection. We aimed to identify factors from routine clinical data which can be used to distinguish people with a high likelihood of having ADPKD in a primary health care setting. A cross-sectional study was undertaken using data from the Quality Intervention in Chronic Kidney Disease trial extracted from 127 primary care practices in England. The health records of 255 people with ADPKD were compared to the general population. Logistic regression was used to identify clinical features which distinguish ADPKD. These clinical features were used to stratify individual risk using a risk score tool. Renal impairment, proteinuria, haematuria, a diastolic blood pressure over 90 mmHg and multiple antihypertensive medications were more common in ADPKD than the general population and were used to build a regression model (area under the receiver operating characteristic curve; 0.79). Age, gender, haemoglobin and urinary tract infections were not associated with ADPKD. A risk score (range -3 to +10) of ≥0 gave a sensitivity of 70.2% and specificity 74.9% of for detection. Stratification of ADPKD likelihood from routine data may be possible. This approach could be a valuable component of future screening programs although further longitudinal analyses are needed.