Prevalence and Predictors of Bleeding Events in Patients with ESKD Who Have Autosomal Dominant Polycystic Kidney Disease: A National Database Analysis

Background: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys, often leading to kidney failure and necessitating dialysis. A critical yet underexplored complication in ADPKD patients undergoing dialysis is the incidence and severity of bleeding. This research aims to systematically investigate the prevalence and risk factors of bleeding in ESKD patients with ADPKD. Methods: ADPKD patients with End Stage Kidney Disease (ESKD) were extracted from the National Inpatient Sample (NIS) database (2016-2018). Demographics, medication history, and comorbidities were extracted from the database using ICD-10 codes. The following bleeding events were analyzed: All Bleeding events, Gastrointestinal (GI) bleeding, Hematuria, Hemorrhagic strokes, Respiratory bleeding, and Other hemorrhages. Patient variables were analyzed using Chi-Square analysis, T-test, and binary logistic regression analysis. P-value < 0.05 was considered significant. Results: Of the 4255 ADPKD patients with ESKD, there were 185 patients with bleeding events. The most common bleeding event was GI bleed (51.9%), followed by hematuria (36.2%), and hemorrhagic strokes (8.6%). Patients that had bleeding were more likely to be older the 65 years old, have chronic heart failure and have coagulable disorders. After binary logistic regression, the factors that predict bleeding events are chronic heart failure (OR: 1.5 [1.1-2.2]; p=0.02), and obesity (OR:1.6 [1.04-2.32], p=0.03). Conclusion: In conclusion, 5% of ESKD patients with ADPKD, have a bleeding event. The predictors of bleeding are chronic heart failure and obesity. Larger prospective studies should be performed to corroborate with our findings.