Association of autosomal dominant polycystic kidney disease with cardiovascular disease: a US-National Inpatient Perspective

• Published in: Clinical and experimental nephrology Vol. 26; no. 7; pp. 659 - 668
• Main Authors: Abou Heidar, Nassib, Chehab, Omar, Morsi, Rami Z., Elias, Joseph, El Mouhayyar, Christopher, Kanj, Amjad, Ajam, Mustafa, Haykal, Abdallah, Pahuja, Mohit, Dakik, Habib, Levine, Diane, Imran, Nashat, Abidov, Aiden
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.07.2022; Springer Nature B.V
• Subjects: Cardiomyopathy; Cardiovascular diseases; Congestive heart failure; Epidemiology; Heart diseases; Hemorrhage; Hospitalization; Ischemia; Kidney diseases; Medicine; Medicine & Public Health; Mortality; Nephrology; Original Article; Polycystic kidney; Population studies; Renal function; Risk factors; Stroke; Urology; Cardiovascular disease; Chronic kidney disease; Autosomal dominant polycystic kidney disease; Mortality
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-022-02200-5

Purpose Data on the epidemiology of cardiovascular diseases (CVD) in patients with autosomal dominant polycystic kidney disease (ADPKD) are limited. In this study, we assess the prevalence of CVD in patients with ADPKD and evaluate associations between these two entities. Methods Using the National Inpatient Sample database, we identified 71,531 hospitalizations among adults aged ≥ 18 years with ADPKD, from 2006 to 2014 and collected relevant clinical data. Results The prevalence of CVD in the study population was 42.6%. The most common CVD were ischemic heart diseases (19.3%), arrhythmias (14.2%), and heart failure (13.1%). The prevalence of CVD increased with the severity of renal dysfunction (RD). We found an increase in hospitalizations of patients with ADPKD and CVD over the years (p trend  < 0.01), irrespective of the degree of RD. CVD was the greatest independent predictor of mortality in these patients (OR: 3.23; 95% CI 2.38–4.38 [ p  < 0.001]). In a propensity matched model of hospitalizations of patients with CKD with and without ADPKD, there was a significant increase in the prevalence of atrial fibrillation/flutter (AF), pulmonary hypertension (PHN), non-ischemic cardiomyopathy (NICM), and hemorrhagic stroke among patients with ADPKD when compared to patients with similar degree of RD without ADPKD. Conclusions The prevalence of CVD is high among patients with ADPKD, and the most important risk factor associated with CVD is severity of RD. We found an increase in the trend of hospitalizations of patients with ADPKD associated with increased risk of AF, PHN, NICM, and hemorrhagic stroke. History of CVD is the strongest predictor of mortality among patients with ADPKD.