Polycystic kidney disease in patients on the renal transplant waiting list: trends in hematocrit and survival

BMC Nephrology

Lawrence Y Agodoa²  Kevin C Abbott¹ 

[1] Nephrology Service, Walter Reed Army Medical Center, Washington, D.C., and Uniformed Services University of the Health Sciences, Bethesda, MD;NIDDK, NIH, Bethesda, MD

关键词: frequency;    mortality;    dysrythmias;    weight;    hemoglobin;    albumin;    age;    USRDS;    dialysis;    complications;    transplantation;    peritoneal dialysis;    EPO;    female;    Caucasian;    Polycystic kidney disease;   

Others  :  1083460
DOI  :  10.1186/1471-2369-3-7

 received in 2002-06-05, accepted in 2002-08-23,  发布年份 2002

【 摘 要 】

Background

The patient characteristics and mortality associated with autosomal dominant polycystic kidney disease (PKD) have not been characterized for a national sample of end stage renal disease (ESRD) patients on the renal transplant waiting list.

Methods

40,493 patients in the United States Renal Data System who were initiated on ESRD therapy between 1 April 1995 and 29 June 1999 and later enrolled on the renal transplant waiting list were analyzed in an historical cohort study of the relationship between hematocrit at the time of presentation to ESRD and survival (using Cox Regression) in patients with PKD as a cause of ESRD.

Results

Hematocrit levels at presentation to ESRD increased significantly over more recent years of the study. Hematocrit rose in parallel in patients with and without PKD, but patients with PKD had consistently higher hemoglobin. PKD was independently associated with higher hematocrit in multiple linear regression analysis (p < 0.0001). In logistic regression, higher hematocrit was independently associated with PKD. In Cox Regression analysis, PKD was associated with statistically significant improved survival both in comparison with diabetic (hazard ratio, 0.64, 95% CI 0.53–0.77, p < 0.001) and non-diabetic (HR 0.68, 95% CI 0.56–0.82, p = 0.001) ESRD patients, adjusted for all other factors.

Conclusions

Hematocrit at presentation to ESRD was significantly higher in patients with PKD compared with patients with other causes of ESRD. The survival advantage of PKD in ESRD persisted even adjusted for differences in hematocrit and in comparison with patients on the renal transplant waiting list.

【 授权许可】

   
2002 Abbott and Agodoa; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

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