AJ MALLETT1,2,3,4,PM SOWA4,5, L WARDROP2, J ZHANG3,4, A CAMERON3,4, WE HOY3,4
1Department of Renal Medicine, Royal Brisbane And Women’s Hospital, Herston, Australia, 2KidGen Collaborative, Australian Genomics Health Alliance, Parkville, Australia, 3Faculty of Medicine, The University of Queensland, Herston, Australia, 4NHMRC CKD.CRE and CKD.QLD, The University of Queensland, Herston, Australia, 5Centre for the Business and Economics of Health, The University of Queensland, Woolloongabba, Australia
Aim: To identify characteristics and health service utilisation (HSU) amongst patients with chronic kidney disease (CKD) due to Autosomal Dominant Polycystic Kidney Disease (ADPKD), non-ADPKD Inherited Kidney Disease (IKD) and all-CKD causes in Queensland.
Background: Those with ADPKD and IKD are an identifiable minority of CKD patients. Their HSU in Australia are not defined.
Methods: Patients with ADPKD and IKD were identified from the CKD.QLD Registry (n=7,541) and a matched Queensland Health CKD cohort (n=22,129) based upon ICD-10 coding. Characteristics and HSU related to hospital presentations were analysed for 5years retrospective from June 2016.
Results: 309 (1.04%) ADPKD and 277 (0.93%) IKD patients were identified from the combined cohort (n=29,670).
The median age at first admission of ADPKD, IKD and All-CKD patients were 53.7, 47.9 and 65.7years respectfully with mean eGFR at CKD.QLD consent being 34.1, 36.5 and 40.8ml/min/1.73m². ADPKD and IKD compared to All-CKD had lower frequency of diabetes (17%vs21%vs48%) and cardiovascular disease (CVD; 34%vs32%vs46%), but similar hypertension (79%vs80%vs81%) and mean body mass index (29.8vs29.2vs31.2). ADPKD and IKD were also associated with a higher incidence than the All-CKD group of dialysis within that 5year period (34%vs24%vs9%).Median hospital admissions excluding those for dialysis were higher in those with ADPKD or IKD compared to All-CKD (7vs8vs4) with similar average length of stay (3.2vs4.4vs3.6days). Median 5year healthcare costs were also higher in those with ADPKD and IKD compared to All-CKD ($42,088vs$45,929vs$16,403).
Conclusions: Those with ADPKD and IKD are younger, with earlier stage CKD and lower prevalence of diabetes and CVD compared to other CKD patients. Despite this, they are more likely to require dialysis within 5years and have increased hospital costs.
A/Prof Andrew Mallett is a Nephrologist with a special interest in inherited kidney disease and nephrogenetics. A/Prof Mallett has undertaken a Churchill Fellowship and been a recurrent Visiting Fellow at Addenbrooke’s Hospital (Cambridge, UK) and the Cambridge Institute for Medical Research. His PhD (2016, University of Queensland) in nephrogenetics involved extensive national and international collaboration. A/Prof Mallett is a Consultant Nephrologist at RBWH and co-lead of the statewide Queensland Conjoint Renal Genetics Service. He is the National Director of the KidGen Collaborative and the AGHA Renal Genetics Flagship.