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Hepatointestinal complications in polycystic kidney disease
#MMPMID29113359
Huang ST
; Chuang YW
; Yu TM
; Lin CL
; Jeng LB
Oncotarget
2017[Oct]; 8
(46
): 80971-80980
PMID29113359
show ga
BACKGROUND: The objective of this study was to determine the incidence of major
hepatointestinal complications in patients with polycystic kidney disease (PKD).
METHODS: We analyzed the Taiwan National Health Insurance claims data (2000-2010)
of 6031 patients with PKD and 23,976 non-PKD hospitalized controls. The control
cohort was propensity score matched with the PKD cohort at a 1:4 ratio. All
patients were followed up from the index date to the first inpatient diagnosis of
hepatointestinal complications, death, or 31 December, 2011. Cox proportional
hazard regression models were used to identify the risk of outcome after
adjustment for potential confounders. RESULTS: The incidence rates of acute
pancreatitis, cholangitis, peptic ulcer bleeding, and cirrhosis were 5.72, 4.01,
19.9, and 5.46 per 1000 person-years, respectively, in the PKD cohort. Compared
with the non-PKD controls, patients with PKD exhibited an increased risk of
hospitalization for acute pancreatitis, cholangitis, peptic ulcer bleeding, and
cirrhosis (adjusted subhazard ratio [aSHR]: 2.36, 95% confidence interval [95%
CI], 1.95-2.84]; 2.36, [95% CI, 1.95-2.84]; 2.41, [95% CI, 1.93-3.01]; 2.41, [95%
CI, 2.17-2.67]; and 1.39, [95% CI, 1.16-1.66], respectively; all p < 0.001). PKD,
chronic kidney disease, and alcoholism were independent predictors of all these
hepatointestinal complications. Kaplan-Meier analysis revealed an increased
overall mortality in patients with PKD who developed acute pancreatitis and
peptic ulcer bleeding (log-rank p < 0.05). CONCLUSION: PKD is associated with
clinically significant extrarenal complications including acute pancreatitis,
cholangitis, peptic ulcer bleeding, and cirrhosis.
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