OBJECTIVES:

Autosomal dominant polycystic kidney disease (ADPKD) is the most common heritable renal disease, characterized by fluid-filled cyst development and variable total kidney volume (TKV) progression. Healthcare utilization (e.g., emergency department [ED] visits) reflect incident cardiovascular and renal events related to ADPKD complications (e.g., hypertension, hematuria and hemorrhaging, acute and chronic pain, urinary tract infections, and renal failure). Recent research has looked at the course of inpatient care for ADPKD patients, however very little is known about their use of EDs, treatment, and progression to the inpatient setting.

METHODS:

A cross-sectional study using the 2010 Nationwide Emergency Department Sample (NEDS) was performed. ADPKD patients were selected using ICD-9-CM: 753.12 and 753.13. Patients were stratified using disposition from ED via transfer to short-term hospital and/or admitted as an inpatient from the ED. CPT/HCPCS and ICD-9-CM code sets were used to identify procedure and diagnosis frequencies among ADPKD patients in the ED setting.

RESULTS:

The study contained a sample of 8,871 ED visits. More females were hospitalized after an ED visit compared to males (51.34% vs. 48.66%, p<0.0001). The hospitalized group was significantly older than their non-hospitalized counterparts (57.86 vs. 42.85, p<0.0001). Mean total charge for ED services were significantly higher in the non-hospitalized group ($4,662.9, SD=$5,968.5) compared to the hospitalized group ($1,703.7, SD=$1,317.2, p<0.0001). Hospitalized visits most frequently occurred due to device complications, implantation, or graft and infections. Among non-hospitalized patients, 30.80% experienced abdominal pain, genitourinary congenital anomalies, and urinary tract infections.

CONCLUSIONS:

ED-based hospitalized patients were mostly admitted due to complications from surgery, whereas non-hospitalized patients appear to be seeking symptom control. A high proportion of patients with ADPKD appear to be readmitted to an inpatient setting through an ED as a result of surgical care. Further research to explore readmission rates post-surgery is needed.