An official website of the United States government
Publication Information
Affiliation
Division of Nephrology and Hypertension and the Kidney Institute, University of Kansas, Medical Center, Kansas City, Kansas, USA. Electronic address: ayu@kumc.edu.; Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.; Division of Nephrology, University of Alabama and the Department of Veterans Affairs Medical Center, Birmingham, Alabama, USA.; Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Division of Nephrology and Hypertension and the Kidney Institute, University of Kansas, Medical Center, Kansas City, Kansas, USA.; Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.; Legacy Good Samaritan Hospital, Portland, Oregon, USA.; Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Section of Nephrology, University of Chicago School of Medicine, Chicago, Illinois, USA.
Authors
Yu Alan S.L., Shen Chengli, Landsittel Douglas P., Harris Peter C., Torres Vicente E., Mrug Michal, Bae Kyongtae Ty, Grantham Jared J., Rahbari-Oskoui Frederic F., Flessner Michael F., Bennett William M., Chapman Arlene B.
Studies
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by
progressive enlargement of kidney cysts leading to chronic kidney disease (CKD)
and end-stage renal disease (ESRD). Identification of an early biomarker that
can predict progression of CKD is urgently needed. In an earlier Consortium for
Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) study (a
prospective, multicenter, observational analysis of 241 patients with ADPKD
initiated in 2000), baseline height-adjusted total kidney volume (htTKV) was
shown to be associated with development of CKD stage 3 after eight years of
follow-up. Here we conducted an extended study and found that in a multivariable
logistic regression model, baseline htTKV was shown to be a strong, independent
predictor for the development of CKD after a median follow-up of 13 years. The
odds ratio of reaching each CKD stage per 100 mL/m increment in htTKV was 1.38
(95% confidence interval 1.19–1.60) for stage 3, 1.42
(1.23–1.64) for stage 4, and 1.35 (1.18–1.55) for stage 5 or
ESRD. Baseline htTKV was also associated with relative decreases in the
glomerular filtration rate of 30%, and 57% or more. Moreover,
the rate of change in htTKV was negatively correlated with the slope of the
glomerular filtration rate. While ADPKD genotype was also associated with CKD
outcomes, it was not an independent prognostic factor after adjusting for htTKV.
Thus, baseline total kidney volume and the rate of kidney growth are strongly
associated with the development of advanced stages of CKD. These findings
support the use of total kidney volume as a prognostic and potentially
monitoring biomarker in ADPKD.