Stefan Zschiedrich1, Klemens Budde2, Jens Nürnberger3, Christoph Wanner4, Claudia Sommerer5, Ulrich Kunzendorf6, Bernhard Banas7, Walter H Hoerl8, Nicholas Obermüller9, Wolfgang Arns10, Hermann Pavenstädt11, Jens Gaedeke2, Tom H Lindner12, Lothar Faerber13, Peter Wimmer13, Roland Stork14, Kai-Uwe Eckardt15, Gerd Walz1. 1. Renal Division, University Hospital Freiburg, Freiburg, Germany. 2. Renal Division, Charité Universitätsmedizin Berlin - Campus Mitte, Berlin, Germany. 3. Department of Nephrology, Helios Kliniken Schwerin, Schwerin, Germany. 4. Renal Division, University Hospital Würzburg, Würzburg, Germany. 5. Center for Nephrology, University Hospital Heidelberg, Heidelberg, Germany. 6. Renal Division, University Hospital Kiel, Kiel, Germany. 7. Renal Division, University Hospital Regensburg, Regensburg, Germany. 8. Department of Internal Medicine III, University Hospital, Vienna, Germany. 9. Renal Division, Center for Internal Medicine, University Hospital Frankfurt, Frankfurt, Germany. 10. Department of Nephrology, Merheim Medical Center, Cologne, Germany. 11. Renal Division, University Hospital Münster, Münster, Germany. 12. Renal Division, University Hospital Leipzig, Leipzig, Germany. 13. Novartis Pharma GmbH, Nuremberg, Germany. 14. Thermo Fisher Scientific, Freiburg, Germany. 15. Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Abstract
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a common autosomal dominant condition associated with renal cysts and development of renal failure. With the availability of potential therapies, one major obstacle remains the lack of readily available parameters that identify patients at risk for disease progression and/or determine the efficacy of therapeutic interventions within short observation periods. Increased total kidney volume (TKV) correlates with disease progression, but it remains unknown how accurate this parameter can predict disease progression at early stages. METHODS: To identify additional parameters that help to stratify ADPKD patients, we measured secreted frizzled-related protein 4 (sFRP4) serum concentrations at baseline and over the course of 18 months in 429 ADPKD patients. RESULTS: Serum creatinine and sFRP4 as well as TKV increased over time, and were significantly different from baseline values within 1 year. CONCLUSION: Elevated sFRP4 levels at baseline predicted a more rapid decline of renal function at 2, 3 and 5 years suggesting that sFRP4 serum levels may provide additional information to identify ADPKD patients at risk for rapid disease progression.
BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) is a common autosomal dominant condition associated with renal cysts and development of renal failure. With the availability of potential therapies, one major obstacle remains the lack of readily available parameters that identify patients at risk for disease progression and/or determine the efficacy of therapeutic interventions within short observation periods. Increased total kidney volume (TKV) correlates with disease progression, but it remains unknown how accurate this parameter can predict disease progression at early stages. METHODS: To identify additional parameters that help to stratify ADPKDpatients, we measured secreted frizzled-related protein 4 (sFRP4) serum concentrations at baseline and over the course of 18 months in 429 ADPKDpatients. RESULTS: Serum creatinine and sFRP4 as well as TKV increased over time, and were significantly different from baseline values within 1 year. CONCLUSION: Elevated sFRP4 levels at baseline predicted a more rapid decline of renal function at 2, 3 and 5 years suggesting that sFRP4 serum levels may provide additional information to identify ADPKDpatients at risk for rapid disease progression.