Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia-Yi, Taiwan.
Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
Aging (Albany NY). 2020 Feb 24;12(4):3899-3910. doi: 10.18632/aging.102858.
There are no specific therapies for autosomal dominant polycystic kidney disease (ADPKD), and clinical data evaluating the effects of non-specific therapies on ADPKD patients are scarce. We therefore evaluated those effects using data from a longitudinal health insurance database collected from 2000-2010. We individually selected patients with and without ADPKD from inpatient data files as well as from the catastrophic illness registry in Taiwan based on 1:5 frequency matching for sex, age, and index year. The hazard ratios (HR) of all-cause mortality, ischemic stroke, hemorrhagic stroke and end-stage renal disease (ESRD) in ADPKD inpatients were elevated as compared to the controls. Similarly, ADPKD patients from the catastrophic illness registry had an increased risk of hemorrhagic stroke and ESRD. Allopurinol users also had an increased risk of all-cause mortality. The HR for developing ESRD after medication exposure was 0.47-fold for statin and 1.93-fold for pentoxifylline. These results reveal that patients with ADPKD (either inpatient or from the catastrophic illness registry) are at elevated risk for hemorrhagic stroke and ESRD, and suggest that allopurinol and pentoxifylline should not be prescribed to ADPKD patients due to possible adverse effects.
对于常染色体显性遗传多囊肾病（ADPKD），目前尚无特定的治疗方法，且临床数据评估非特异性治疗对 ADPKD 患者的效果也十分有限。因此，我们利用 2000 年至 2010 年期间收集的纵向医疗保险数据库中的数据来评估这些效果。我们根据性别、年龄和索引年，在台湾的住院数据文件和灾难性疾病登记处中，对每例 ADPKD 患者和无 ADPKD 患者进行 1:5 的频数匹配，以单独选择患者。与对照组相比，ADPKD 住院患者的全因死亡率、缺血性卒中和出血性卒中和终末期肾病（ESRD）的风险比（HR）均升高。同样，灾难性疾病登记处的 ADPKD 患者发生出血性卒中和 ESRD 的风险也增加。别嘌醇使用者的全因死亡率也增加。与药物暴露后发生 ESRD 的风险比（HR）相比，他汀类药物为 0.47 倍，己酮可可碱为 1.93 倍。这些结果表明，ADPKD（住院或灾难性疾病登记处）患者发生出血性卒中和 ESRD 的风险较高，并表明别嘌醇和己酮可可碱可能会对 ADPKD 患者产生不良反应，因此不应为 ADPKD 患者开具处方。
