Autosomal Dominant Polycystic Kidney Disease Does Not Significantly Alter Major COVID-19 Outcomes among Veterans

Cui, Xiangqin; Gallini, Julia W.; Jasien, Christine; Mrug, Michal

doi:10.34067/kid.0007282020

Cited by 4 publications

(8 citation statements)

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“…We initially used this cohort for analyses centered on coronavirus disease 2019 outcomes among veterans with ADPKD. 12 By contrast, the current manuscript is focused on a more systematic assessment of ADPKD relevant demographic and clinical data (see below). This study was approved by the Emory University Institutional Review Board (IRB00115069).…”

Section: Methodsmentioning

confidence: 99%

US Veterans Administration Autosomal Dominant Polycystic Kidney Disease Cohort: Demographic, Comorbidity, and Key Laboratory Data Characteristics

Gallini,

Jasien,

Mrug

et al. 2024

Kidney360

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Background We used the largest integrated US health care system, the Veterans Health Administration (VHA), to establish a robust resource for demographic, longitudinal outcome, and predictive modeling studies in autosomal dominant polycystic kidney disease (ADPKD). Methods We built the ADPKD cohort by extracting the relevant electronic health record (EHR) data from nationwide VHA database (years 1999-2020). Results We identified 12,217 patients diagnosed with ADPKD. By the end of the 20-year study period, 5,342 ADPKD patients were deceased, 1,583 were alive but reached end-stage kidney disease (ESKD), and 4,827 remained alive without ESKD. Most demographic characteristics of this ADPKD cohort resemble the total U.S. veteran population. For example, 94% were males, 45% age 65 years or older, 85% non-Hispanic, 66% white; however, 19% were Black/African Americans (vs. 12% in the general veteran population; a relevant enrichment after considering age and sex distributions between races). The comorbidities overrepresented in the ADPKD cohort include hypertension (89% vs. 50%), diabetes (32% vs. 22%), depression (40% vs. 10%), chronic obstructive pulmonary disease (30% vs 6%), and congestive heart failure (21% vs 1%). In contrast, obesity was under-represented in veterans with ADPKD (30% vs 41%). Conclusions We established a large EMR-based cohort of ADPKD veterans. Here we provide initial analysis of its demographic, comorbidity and key laboratory data.

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Section: Methodsmentioning

confidence: 99%

US Veterans Administration Autosomal Dominant Polycystic Kidney Disease Cohort: Demographic, Comorbidity, and Key Laboratory Data Characteristics

Gallini,

Jasien,

Mrug

et al. 2024

Kidney360

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“…Among hospitalized patients receiving RAAS blockers, the risk of AKI is not higher in those receiving concurrent NSAIDs versus opioids for analgesia 49 Prior use of RAAS inhibitors is not associated with adverse outcomes in patients hospitalized with COVID-19 50 Higher FGF23 levels in outpatients are not associated with a higher risk of sepsis 51 Short-term rifaximin does not lower gut-derived cardiovascular toxins and inflammatory cytokines in patients with chronic kidney disease 52 Autosomal dominant polycystic disease does not increase the risk of starting dialysis after COVID-19 53 Pkd1 mutation does not impair lipid metabolism 54 Proactive intravenous iron administration does not increase the risk of stroke in hemodialysis patients 55 Bleeding after a kidney biopsy is not more likely in obese patients 56 RAAS, renin-angiotensin-aldosterone system; NSAID, nonsteroidal anti-inflammatory drug; COVID-19, coronavirus disease 2019; FGF23, fibroblast growth factor 23.…”

Section: Table 2 Examples Of Negative Studies Published In Kidney360mentioning

confidence: 99%

Reproducibility in Research: The Role of Kidney360

2023

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“…A report first distributed as an unpublished preprint analysis did not show an increase in hospitalization, intensive care unit admission, intubation, or mortality following COVID-19 infection in patients with ADPKD compared with patients with other cystic kidney or cystic liver diseases. 6 It should be noted that preprint reports have not been peer reviewed but are a growing resource for early access to research results, 7 and this report was subsequently published. 8 Of 709 veterans with ADPKD tested for COVID-19 in Atlanta in January 2020, 61 (8.6%) had a positive test and were compared to 9817 veterans with non-ADPKD cystic kidney or liver disease tested for COVID-19 of which 803 (8.2%) had a positive test.…”

Section: Does Adpkd Affect the Likelihood Of Developing Covid-19?mentioning

confidence: 99%

“…Symptoms in those affected with COVID-19 were no different in those with ADPKD compared with those with non-ADPKD cystic kidney or liver disease. 6 While the data remain very limited, the biggest risk factor for COVID-19 is exposure to SARS-CoV-2, and it is unlikely that ADPKD significantly modifies this risk.…”

Section: Does Adpkd Affect the Likelihood Of Developing Covid-19?mentioning

confidence: 99%

“…6 It should be noted that preprint reports have not been peer reviewed but are a growing resource for early access to research results, 7 and this report was subsequently published. 8 Of 709 veterans with ADPKD tested for COVID-19 in Atlanta in January 2020, 61 (8.6%) had a positive test and were compared to 9817 veterans with non-ADPKD cystic kidney or liver disease tested for COVID-19 of which 803 (8.2%) had a positive test. Symptoms in those affected with COVID-19 were no different in those with ADPKD compared with those with non-ADPKD cystic kidney or liver disease.…”

Section: Clinical Questionsmentioning

confidence: 99%

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The Impact of COVID-19 on Patients With ADPKD

Kutky

Cross

Treleaven

et al. 2021

Can J Kidney Health Dis

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Purpose of review: Patients with autosomal dominant polycystic kidney disease (ADPKD) have kidney cysts and kidney enlargement decades before progressing to advanced chronic kidney disease (CKD), meaning patients live most of their adult life with a chronic medical condition. The coronavirus disease 2019 (COVID-19) pandemic has created common questions among patients with ADPKD. In this review, we discuss COVID-19 concerns centered around a patient with a common clinical vignette. Sources of information: We performed PubMed and Google scholar searches for English, peer-reviewed studies related to “COVID-19,” “ADPKD,” “CKD,” “tolvaptan,” “angiotensin-converting enzyme inhibitors” (ACEi), “angiotensin receptor blockers” (ARB), and “vaccination.” We also evaluated transplant data provided by the Ontario Trillium Gift of Life Network. Methods: Following an assessment of available literature, this narrative review addresses common questions of patients with ADPKD in the context of the COVID-19 pandemic. Key findings: Data regarding the risk of developing COVID-19 and the risk of adverse COVID-19 outcomes in patients with ADPKD remain limited, but patients with ADPKD with impaired estimated glomerular filtration rate (eGFR), kidney transplants, or on dialysis are likely at similar increased risk as those with generally defined CKD. We provide strategies to improve virtual care, which is likely to persist after the pandemic. Current evidence suggests ACEi, ARB, and tolvaptan treatment should be continued unless contraindicated due to severe illness. When available, and in the absence of a severe allergy, vaccination is recommended for all patients with ADPKD. Limitations: This narrative review is limited by a paucity of high-quality data on COVID-19 outcomes in patients specifically with ADPKD. Implications: Patients with ADPKD who have developed advanced CKD, require dialysis, or who have received a kidney transplant are at elevated risk of COVID-19 complications.

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Autosomal Dominant Polycystic Kidney Disease Does Not Significantly Alter Major COVID-19 Outcomes among Veterans

Abstract: This is an Early Access article. Please select the PDF button, above, to view it.

Cited by 4 publications

References 14 publications

US Veterans Administration Autosomal Dominant Polycystic Kidney Disease Cohort: Demographic, Comorbidity, and Key Laboratory Data Characteristics

US Veterans Administration Autosomal Dominant Polycystic Kidney Disease Cohort: Demographic, Comorbidity, and Key Laboratory Data Characteristics

Reproducibility in Research: The Role of Kidney360

The Impact of COVID-19 on Patients With ADPKD

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