Improved prognosis in patients with autosomal dominant polycystic kidney disease in Denmark.
OBJECTIVE
The introduction of new therapies, including agents that block the renin-angiotensin system, may have affected progression of autosomal dominant polycystic kidney disease (ADPKD). We investigated whether the age when reaching ESRD and survival during renal replacement therapy in Danish patients with ADPKD changed from January 1, 1990, through December 31, 2007.


METHODS
According to the Danish National Registry on Regular Dialysis and Transplantation, 693 patients with ADPKD reached ESRD in the study period. The 18 years were divided into three consecutive 6-year intervals.


RESULTS
The incidence of reaching ESRD for patients with ADPKD increased from 6.45 per million people in 1990 through 1995 to 7.59 per million people in 2002 through 2007, and the mean age at onset of ESRD increased by 4.7 years. The age-adjusted male-to-female ratio for onset of ESRD changed from 1.6 to 1.1, indicating a trend toward similar progression in both genders. From onset of ESRD, a Cox regression analysis to compare the first and second 6-year intervals, adjusted for age, gender, and treatment modality, showed that patient survival improved by 38%. Although NS, a similar trend was found during the second and third time intervals.


CONCLUSIONS
This study demonstrates that in Danish patients with ADPKD, the prognosis had significantly improved during the study period. Furthermore, the results indicate that male gender may be losing its importance as a risk factor for progression in ADPKD.
Orskov
Bjarne
B
Department of Nephrology, Copenhagen University Hospital, Herlev, Denmark. bjorch02@heh.regionh.dk
Rømming Sørensen
Vibeke
V
Feldt-Rasmussen
Bo
B
Strandgaard
Svend
S
D017668:Age of Onset; D003718:Denmark / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000401:mortality / Q000628:therapy*; D015995:Prevalence; D016016:Proportional Hazards Models; D012042:Registries; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome