INTRODUCTION: Research has suggested racial differences among ADPKD patients in access to treatment, disease progression, and mortality. Recent work estimated mortality rates for ADPKD patients aged 65 years and older with ESRD. This analysis sought to estimate race-specific mortality among elderly ADPKD patients in CKD stages 1 through 5 (i.e., non-ESRD CKD) and ESRD.
METHODS: Patients aged 65 years and older with ADPKD in the USRDS were studied. Patients in the 2014, 2015, or 2016 USRDS non-ESRD CKD cohort (assembled from Medicare claims data 5% sample) with at least two records with an ADPKD diagnosis code were included. CKD stage, determined based on at least two consecutive stage diagnosis codes, and age were determined at study entry. ESRD patients with at least one ADPKD diagnosis code and an ESRD service date from January 1, 2014, to December 31, 2016, were included. Mortality rates were estimated by race, by sex, by stage, by age group, and overall.
RESULTS 1,551 elderly ADPKD patients with non-ESRD CKD meeting staging criteria (0.089% of non-ESRD CKD cohort) were identified (mean 76.5 years; 54.4% male). 14,756 elderly ADPKD patients with ESRD (0.460% of ESRD cohort) were identified (mean 70.8 years; 50.4% male). Age-adjusted mortality was highest for black patients in the non-ESRD CKD cohort and highest for white patients in the ESRD cohort. Our results show racial differences in mortality among elderly ADPKD patients in both non-ESRD CKD and ESRD cohorts and suggest a possible survivorship effect among elderly black ADPKD patients with ESRD.
CONCLUSION: Our results show racial differences in mortality among elderly ADPKD patients in both non-ESRD CKD and ESRD cohorts and suggest a possible survivorship effect among elderly black ADPKD patients with ESRD.
