Prevalence of Cardiovascular Events in Patients with Autosomal Dominant Polycystic Kidney Disease

Abstract

Background: This study evaluates the prevalence of cardiovascular events in autosomal dominant polycystic kidney disease (ADPKD) patients. Methods: We distributed surveys to 1,439 subjects from our ADPKD research database. In total, 426 subjects completed and returned surveys; 7 of these were from children and were excluded from the study. Results: The patients who responded were female (63.2%), nonHispanic (88.1%) and white (93.6%). The mean age of the total group was 53.2 ± 13.7 years; 82.8% had a family history of ADPKD and 32.5% had reached end-stage renal disease (ESRD). With respect to cardiovascular risk factors, 86.6% were hypertensive with a mean age at diagnosis of 36.9 ± 12.9 years and hypertension was significantly more prevalent in males. In addition, 19.6% of the subjects were obese, 20.8% were smokers, 8.7% had diabetes, 45.7% had high cholesterol and 17.8% were sedentary. The most prevalent self-reported cardiovascular events were arrhythmias (25.9%), evidence of peripheral vascular disease (16.5%), heart valve problems (14.4%), cardiac enlargement (9.5%), stroke or cerebral bleeding (7.5%), myocardial infarction (6%) and brain aneurysm (5.0%). The most commonly used antihypertensive medications were renin-angiotensin inhibitors used by 75% of ADPKD patients.Older ADPKD patients and those at ESRD had a significantly higher incidence of cardiovascular events. Conclusion: These findings support the high prevalence of cardiovascular risk factors and events in ADPKD patients which contribute to a greater mortality risk. Due to the prevalence of cardiovascular risk factors in the ADPKD population, early diagnosis and clinical intervention are recommended.

Native Nephrectomy with Renal Transplantation is Associated with a Decrease in Hypertension Medication Requirements for Autosomal Dominant Polycystic Kidney Disease

“…We did find male gender was predictive of greater DDD of antihypertensives on multivariable regression analysis, which is consistent with previous studies showing male gender as a risk factor for HTN in this population. [8] We found a decrease in quantity and DDD of antihypertensives in the group who had renal Tx alone, although this decrease was significantly less than that in the Tx/Nx group. [ 16,17] Our findings are novel and contradictory to these other studies that have examined this intervention.…”

“…[7] When end stage renal disease (ESRD) occurs in ADPKD, there is also increased risk of other cardiovascular events. [8] Renal transplantation(Tx) is the treatment of choice for ESRD.…”

A Link between the Intrarenal Renin Angiotensin System and Hypertension in Autosomal Dominant Polycystic Kidney Disease

“…Progressing to end-stage renal failure without any intervention and cardiovascular problems due to hypertension are the prominent features of ADPKD [3,5,6]. Hypertension, which is directly related to cardiovascular problems, accounts for the great majority of deaths in this population [3,7].…”

“…Early onset of hypertension is a well-known entity in ADPKD patients compared to the general population [4]. Furthermore, hypertension is associated with rapid progression to ESRD and increased cardiovascular events [5,6]. Cardiovascular disease due to hypertension remains the main cause of mortality in ADPKD patients [7].…”

The relation of anthropometric measurements and insulin resistance in patients with polycystic kidney disease

“…[13] Tirosh et al showed that weight loss improves renal functions [30] . Because approximately 600,000 Americans are affected with ADPKD and more than 2,000 patients are starting dialysis every year, early interventions to slow down the progress are essential in ADPKD [31] .…”