BACKGROUND AND OBJECTIVES: Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal function. Magnetic resonance imaging and iothalamate clearance were used to measure htTKV and GFR, respectively. The association between baseline htTKV and the attainment of stage 3 CKD (GFR <60 ml/min per 1.73 m(2)) during follow-up was determined. RESULTS: After a mean follow-up of 7.9 years, stage 3 CKD was attained in 30.7% of the enrollees. Using baseline htTKV, negative correlations with GFR increased from -0.22 at baseline to -0.65 at year 8. In multivariable analysis, a baseline htTKV increase of 100 cc/m significantly predicted the development of CKD within 8 years with an odds ratio of 1.48 (95% confidence interval: 1.29, 1.70). In receiver operator characteristic curve analysis, baseline htTKV of 600 cc/m most accurately defined the risk of developing stage 3 CKD within 8 years with an area under the curve of 0.84 (95% confidence interval: 0.79, 0.90). htTKV was a better predictor than baseline age, serum creatinine, BUN, urinary albumin, or monocyte chemotactic protein-1 excretion (P<0.05). CONCLUSIONS: Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.
BACKGROUND AND OBJECTIVES:Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal function. Magnetic resonance imaging and iothalamate clearance were used to measure htTKV and GFR, respectively. The association between baseline htTKV and the attainment of stage 3 CKD (GFR <60 ml/min per 1.73 m(2)) during follow-up was determined. RESULTS: After a mean follow-up of 7.9 years, stage 3 CKD was attained in 30.7% of the enrollees. Using baseline htTKV, negative correlations with GFR increased from -0.22 at baseline to -0.65 at year 8. In multivariable analysis, a baseline htTKV increase of 100 cc/m significantly predicted the development of CKD within 8 years with an odds ratio of 1.48 (95% confidence interval: 1.29, 1.70). In receiver operator characteristic curve analysis, baseline htTKV of 600 cc/m most accurately defined the risk of developing stage 3 CKD within 8 years with an area under the curve of 0.84 (95% confidence interval: 0.79, 0.90). htTKV was a better predictor than baseline age, serum creatinine, BUN, urinary albumin, or monocyte chemotactic protein-1 excretion (P<0.05). CONCLUSIONS: Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKDpatients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.
Authors: Andreas L Serra; Diane Poster; Andreas D Kistler; Fabienne Krauer; Shagun Raina; James Young; Katharina M Rentsch; Katharina S Spanaus; Oliver Senn; Paulus Kristanto; Hans Scheffel; Dominik Weishaupt; Rudolf P Wüthrich Journal: N Engl J Med Date: 2010-06-26 Impact factor: 91.245
Authors: Gerd Walz; Klemens Budde; Marwan Mannaa; Jens Nürnberger; Christoph Wanner; Claudia Sommerer; Ulrich Kunzendorf; Bernhard Banas; Walter H Hörl; Nicholas Obermüller; Wolfgang Arns; Hermann Pavenstädt; Jens Gaedeke; Martin Büchert; Christoph May; Harald Gschaidmeier; Stefan Kramer; Kai-Uwe Eckardt Journal: N Engl J Med Date: 2010-06-26 Impact factor: 91.245
Authors: Jared J Grantham; Vicente E Torres; Arlene B Chapman; Lisa M Guay-Woodford; Kyongtae T Bae; Bernard F King; Louis H Wetzel; Deborah A Baumgarten; Phillip J Kenney; Peter C Harris; Saulo Klahr; William M Bennett; Gladys N Hirschman; Catherine M Meyers; Xiaoling Zhang; Fang Zhu; John P Miller Journal: N Engl J Med Date: 2006-05-18 Impact factor: 91.245
Authors: N Hateboer; M A v Dijk; N Bogdanova; E Coto; A K Saggar-Malik; J L San Millan; R Torra; M Breuning; D Ravine Journal: Lancet Date: 1999-01-09 Impact factor: 79.321
Authors: S Klahr; J A Breyer; G J Beck; V W Dennis; J A Hartman; D Roth; T I Steinman; S R Wang; M E Yamamoto Journal: J Am Soc Nephrol Date: 1995-06 Impact factor: 10.121
Authors: Robert W Schrier; Kaleab Z Abebe; Ronald D Perrone; Vicente E Torres; William E Braun; Theodore I Steinman; Franz T Winklhofer; Godela Brosnahan; Peter G Czarnecki; Marie C Hogan; Dana C Miskulin; Frederic F Rahbari-Oskoui; Jared J Grantham; Peter C Harris; Michael F Flessner; Kyongtae T Bae; Charity G Moore; Arlene B Chapman Journal: N Engl J Med Date: 2014-11-15 Impact factor: 91.245
Authors: Marie C Hogan; Tetyana V Masyuk; Linda Page; David R Holmes; Xujian Li; Eric J Bergstralh; Maria V Irazabal; Bohyun Kim; Bernard F King; James F Glockner; Nicholas F Larusso; Vicente E Torres Journal: Nephrol Dial Transplant Date: 2012-07-06 Impact factor: 5.992
Authors: Emilie Cornec-Le Gall; Rory J Olson; Whitney Besse; Christina M Heyer; Vladimir G Gainullin; Jessica M Smith; Marie-Pierre Audrézet; Katharina Hopp; Binu Porath; Beili Shi; Saurabh Baheti; Sarah R Senum; Jennifer Arroyo; Charles D Madsen; Claude Férec; Dominique Joly; François Jouret; Oussamah Fikri-Benbrahim; Christophe Charasse; Jean-Marie Coulibaly; Alan S Yu; Korosh Khalili; York Pei; Stefan Somlo; Yannick Le Meur; Vicente E Torres; Peter C Harris Journal: Am J Hum Genet Date: 2018-04-26 Impact factor: 11.025
Authors: Carolina I Galarreta; Jared J Grantham; Michael S Forbes; Robin L Maser; Darren P Wallace; Robert L Chevalier Journal: Am J Pathol Date: 2014-05-09 Impact factor: 4.307