scholarly journals Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 ◽  
pp. 205435812093462 ◽  
Author(s):  
Vinusha Kalatharan ◽  
Gary Grewal ◽  
Danielle M Nash ◽  
Blayne Welk ◽  
Sisira Sarma ◽  
...  

Background: It is uncertain how often patients with autosomal dominant polycystic kidney disease (ADPKD) develop kidney stones. Objective: To review English-language studies reporting the incidence and prevalence of stones and stone interventions in adults with ADPKD. Design: Systematic review and meta-analysis. Setting: Any country of origin. Patients: Adult patients with ADPKD. Measurements: Incidence or prevalence of kidney stones and stone interventions. Methods: We reviewed 1812 citations from bibliographic databases, abstracted data from 49 eligible studies, and assessed methodological quality in duplicate. In some studies, the proportion of adults with ADPKD with the outcome were compared to adults without ADPKD; for these studies, prevalence risk ratios were calculated and pooled using a random effects model. Results: We identified 49 articles that met our review criteria. The methodological quality of many studies was limited (scores ranging from 2 to 14 out of 22, with a higher score indicating higher quality). No study clearly reported stone incidence, and in the cross-sectional studies, the definition of stones was often unclear. The prevalence of stones ranged from 3% to 59%, and a prevalence of stone interventions ranged from 1% to 8%; the average patient age at the time of assessment ranged from 26 to 61 years across the studies. Two studies reported a nonstatistically significant higher stone prevalence in patients with ADPKD compared to unaffected family members. Compared to unaffected family members, patients with ADPKD had a higher prevalence of kidney stones (6 cross-sectional studies; unadjusted prevalence ratio: 1.8; 95% confidence interval: 1.3 to 2.6; P = .0007; test for heterogeneity: I2 = 0%, P = .8). Limitations: Studies were limited to articles published in English. Conclusions: The prevalence of kidney stones and stone interventions in adults with ADPKD remains uncertain. Future studies of higher methodological quality are needed to better characterize the incidence and prevalence of kidney stones in patients with ADPKD. Trial registration: We did not register the protocol for this systematic review.

2016 ◽  
Vol 101 (12) ◽  
pp. 1142-1147 ◽  
Author(s):  
Matko Marlais ◽  
Oliver Cuthell ◽  
Dean Langan ◽  
Jan Dudley ◽  
Manish D Sinha ◽  
...  

ContextAutosomal dominant polycystic kidney disease (ADPKD) is a common disorder that can cause hypertension during childhood, but the true prevalence of hypertension during childhood is not known.ObjectiveWe undertook a systematic review and meta-analysis to determine the prevalence of hypertension in children with ADPKD.Data sourcesSystematic review of articles published between 1980 and 2015 in MEDLINE and EMBASE.Study selectionStudies selected by two authors independently if reporting data on prevalence of hypertension in children and young persons aged <21 years with a diagnosis of ADPKD. Observational series were included with study populations of >15 children. Articles were excluded if inadequate diagnostic criteria for hypertension were used. Studies with selection bias were included but analysed separately.Data extractionData extracted on prevalence of hypertension, proteinuria and reduced renal function using standardised form. Meta-analysis was performed to calculate weighted mean prevalence.Results903 articles were retrieved from our search; 14 studies met the inclusion criteria: 1 prospective randomised controlled trial; 8 prospective observational studies; and 5 retrospective cross-sectional studies. From 928 children with clinically confirmed ADPKD, 20% (95% CI 15% to 27%) were hypertensive. The estimated prevalence of proteinuria in children with ADPKD is 20% (8 studies; 95% CI 9% to 40%) while reduced renal function occurred in 8% (5 studies; 95% CI 2% to 26%).LimitationsStudies showed a high degree of methodological heterogeneity (I2=73.4%, τ2=0.3408, p<0.0001). Most studies did not use ambulatory blood pressure (BP) monitoring to diagnose hypertension.ConclusionsIn this meta-analysis we estimate 20% of children with ADPKD have hypertension. In the population, many children with ADPKD are not under regular follow-up and remain undiagnosed. We recommend that all children at risk of ADPKD have regular BP measurement.


2021 ◽  
Vol 8 ◽  
pp. 205435812110002
Author(s):  
Vinusha Kalatharan ◽  
Blayne Welk ◽  
Danielle M. Nash ◽  
Stephanie N. Dixon ◽  
Justin Slater ◽  
...  

Background: There is a perception that patients with autosomal dominant polycystic kidney disease (ADPKD) are more likely to develop kidney stones than the general population. Objective: To compare the rate of hospital encounter with kidney stones and the rate of stone interventions between patients with and without ADPKD. Design: Retrospective cohort study. Setting: Ontario, Canada. Patients: Patients with and without ADPKD who had a prior hospital encounter between 2002 and 2016. Measurements: Rate of hospital encounter with kidney stones and rate of stone intervention. Methods: We used inverse probability exposure weighting based on propensity scores to balance baseline indicators of health between patients with and without ADPKD. We followed each patient until death, emigration, outcomes, or March 31, 2017. We used a Cox proportional hazards model to compare event rates between the two groups. Results: Patients with ADPKD were at higher risk of hospital encounter with stones compared with patients without ADPKD (81 patients of 2094 with ADPKD [3.8%] vs 60 patients of 1902 without ADPKD [3.2%]; 8.9 vs 5.1 events per 1000 person-years; hazard ratio 1.6 [95% CI, 1.3-2.1]). ADPKD was not associated with a higher risk of stone intervention (49 of 2094 [2.3%] vs 47 of 1902 [2.4%]; 5.3 vs 3.9 events per 1000 person-years; hazard ratio 1.2 [95% CI = 0.9-1.3]). Limitations: We did not have information on kidney stone events outside of the hospital. There is a possibility of residual confounding. Conclusion: ADPKD was a significant risk factor for hospital encounters with kidney stones.


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