​ADPKD Disparities

• Epidemiologic studies have not demonstrated differences in the incidence of ADPKD according to racial or ethnic identity (13).

• Whether Black race is associated with a higher risk of progression to ESKD in patients with ADPKD remains controversial with arguments for (14,15) and against (16) considering race as a risk factor in ADPKD.

• Large cohort studies have shown that, compared to Whites, Black patients with ADPKD reach ESKD at a younger age (13,14).

• Black patients with ADPKD were less than half as likely to receive a preemptive transplant, compared with White patients (OR = 0.33; 95% confidence interval, 0.29 to 0.38) (13).

• Health disparities result in poorer outcomes for patients with ADPKD who are Black, largely attributed to lack of access and institutional racism (13).

• The use of race adjustment in the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations overestimates eGFR, potentially leading to underestimates of kidney disease severity and delayed treatment (17).

• The National Kidney Foundation and American Society of Nephrologists recommend use of race-free GFR estimating equations (18) .

• Compared to Black and Hispanic patients, less is known about ADPKD in patients who are Asian (19).

• In a large US study of patients with ADPKD, a higher percentage of Black and non-Hispanic White patients had kidney failure, compared to Hispanic and Asian patients (20).