Hepatointestinal complications in polycystic kidney disease

Abstract

BackgroundThe objective of this study was to determine the incidence of major hepatointestinal complications in patients with polycystic kidney disease (PKD).MethodsWe analyzed the Taiwan National Health Insurance claims data (2000–2010) of 6031 patients with PKD and 23,976 non-PKD hospitalized controls. The control cohort was propensity score matched with the PKD cohort at a 1:4 ratio. All patients were followed up from the index date to the first inpatient diagnosis of hepatointestinal complications, death, or 31 December, 2011. Cox proportional hazard regression models were used to identify the risk of outcome after adjustment for potential confounders.ResultsThe incidence rates of acute pancreatitis, cholangitis, peptic ulcer bleeding, and cirrhosis were 5.72, 4.01, 19.9, and 5.46 per 1000 person-years, respectively, in the PKD cohort. Compared with the non-PKD controls, patients with PKD exhibited an increased risk of hospitalization for acute pancreatitis, cholangitis, peptic ulcer bleeding, and cirrhosis (adjusted subhazard ratio [aSHR]: 2.36, 95% confidence interval [95% CI], 1.95–2.84]; 2.36, [95% CI, 1.95–2.84]; 2.41, [95% CI, 1.93–3.01]; 2.41, [95% CI, 2.17–2.67]; and 1.39, [95% CI, 1.16–1.66], respectively; all p < 0.001). PKD, chronic kidney disease, and alcoholism were independent predictors of all these hepatointestinal complications. Kaplan–Meier analysis revealed an increased overall mortality in patients with PKD who developed acute pancreatitis and peptic ulcer bleeding (log-rank p < 0.05).ConclusionPKD is associated with clinically significant extrarenal complications including acute pancreatitis, cholangitis, peptic ulcer bleeding, and cirrhosis.

Bacterial Cholangitis in Autosomal Dominant Polycystic Kidney and Liver Disease

“…Hospitalization rates in the United Kingdom for biliary tract disease were higher in patients with ADPKD than in non-ADPKD controls (relative risk, 2.24; 95% CI, 2.16-2.33) 11 . Hospitalization for cholangitis in Taiwan during 2000-2010 was higher in patients with ADPKD than in non-ADPKD controls (hazard ratio, 2.41; 95% CI, 1.93-3.01) 12 …”