Studies on comorbidities seen with CKD reviewed here examine controlled vs uncontrolled gout, psychiatric diagnoses, and screening for intracranial aneurysm.
Comorbidities in an early diagnosed cohort of uncontrolled vs controlled gout: analysis of a large US database. Francis-Sedlak M, LaMoreaux B, Holt RJ. Ann Rheum Dis. 2019 Jun 15. doi: 10.1136/annrheumdis-2019-eular.2889
Conclusions/Research Questions. Does hyperuricemia in uncontrolled gout lead to specific cardiovascular and renal comorbidities? Or, do specific cardiovascular and renal diseases lead to hyperuricemia and uncontrolled gout?
Psychiatric illness and mortality in hospitalized ESKD dialysis patients. Kimmel PL, Fwu C-W, Abbott KC, et al. CJASN ePress. 2019 Aug 22. doi: 10.2215/CJN.14191218
Examined Psychiatric Dx and All-cause Death in Adults. Analysis of inpatient claims from 1st year of ESKD in adult & pediatric Medicare recipients starting treatment between 1996 - 2013.
Depression, Dementias Most Common. Most common dx: Adults/peds: depression/affective disorder; elderly: organic disorders/dementias
Hospitalizations with psychiatric dx increased over time, mainly due to secondary diagnoses. All-cause death in adults on dialysis: HR higher for hospitalization with primary and secondary psychiatric dx vs those hospitalized without psychiatric dx.
True Burden of Mental Ilness Likely Underestimated. Hospitalizations with psychiatric dx were found common in both pediatric and adult ESKD patients. Associated with higher subsequent mortality in adult dialysis patients. Prevalence of hospitalizations with psychiatric dx likely underestimates true burden of mental illness in ESKD population.
Presymptomatic screening for intracranial aneurysms in patients with autosomal polycystic kidney disease. Sanchis IM, Shukoor S, Irazabal MV, et al. Clin J Am Soc Nephrol. 20197;14:1151-1160.
doi: 10.2215/CJN.14691218. Epub 2019 Jul 30.
Aneurysm Rupture is a Devastating Complication of ADPKD. Current study reviewed results of presymptomatic screening and incidence of intracranial aneurysm in patients newly diagnosed with ADPKD. Records of patients with ADPKD (N = 3010) were evaluated at the Mayo Clinic between 1989 - 2017.
Anuerysms Found in 9% of Patients. 94 intracranial aneurysms found in 75 of 812 (9%) patients undergoing MRA screening. No differences were seen in sex, age, race, or genotype between groups with and without aneurysms.
Most Lesions were Small. Most aneurysms were small (median diameter, 4 mm); 85% in anterior circulation. New intracranial aneurysms found in 5 patients over follow-up of 469 patient-years. Outcomes in 737 pts with no intracranial aneurysm on first MRA screening (follow-up, 4783 patient-years): rupture in 2 pts (0.04 per 100 person-years; 95% CI, 0 - 0.10).
Comorbidites seen with chronic kidney disease can be devastating. In the slides below we highlight research from recent meetings and the literature on:â Prevalence of chronic kidney disease (CKD) in uncontrolled vs controlled gout â Psychiatric diagnoses in hospitalized ESKD patients â Screening for intracranial aneurysms in patients with ADPKD