Charles Vega, MD: Atrial Fibrillation, Risk Factors for Autosomal Dominant Polycystic Kidney Disease

An interview with Dr. Vega regarding atrial fibrillation and clinical manifestations for ADPKD.

In a segment of his interview with HCPLive, Charles Vega, MD, the Health Sciences Clinical Professor at the UC Irvine Department of Family Medicine, further explained elements of his Pri-Med Midwest 2022 presentation.

Vega’s academic interests involve working toward better access to quality, compassionate medical care for populations who are underserved as well as the development of training programs to support this idea.

In the interview segment, Vega described points of interest for primary care clinicians regarding the risk factors and clinical manifestations of autosomal dominant polycystic kidney disease (ADPKD), the genetic disorder known to be the most common form of PKD.

“ADPKD is a lot more common than I think we in primary care give it credit for,” Vega said. “That mutation is present in about one in 1000 folks, so it's one of the most common genetic syndromes we see. And it is highly consequential in terms of the risk of renal failure, needing a renal replacement therapy, and contributing to cardiovascular disease as well. And ultimately, death. ADPKD is important to spot early.”

Vega also added how persistent, unexplained flank pain can be one of the giveaways for ADPKD and that those with hematuria blood in their urine may need a kidney ultrasound.

“I think one of the clearest things that I use is hypertension, hypertension, maybe they don't meet the phenotype that we usually see with hybrid hypertension, older maybe with more obesity and other metabolic disease,” Vega explained. “This is a younger adult who has a normal weight, but has really not just hypertension, but significant hypertension, that's hard to control. So when we think about secondary causes of hypertension, those individuals with ADPKD should be right up there.”

The discussion shifted to the subject of gaps in research regarding either harms or benefits of screening for atrial fibrillation that should be addressed by clinicians.

“I think that atrial fibrillation is the most consequential…when you look at the public health consequences of it, because it is the most common serious arrhythmia, and it's associated with a significant elevated risk of stroke for many folks,” he said. “There are well validated devices out there which are fairly expensive, which can track heart rate. So I think therefore, we are entering a new paradigm when it comes to screening for atrial fibrillation, it's going to be a lot more available. And so therefore, I actually think that it's something whose time has come. We screen for it all the time.”

View the other interview segments with Dr. Vega to learn more about takeaways from his Pri-Med Midwest presentation.

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