Clinical characteristics and predictors of progression of chronic kidney disease in autosomal dominant polycystic kidney
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ORIGINAL ARTICLE
Clinical characteristics and predictors of progression of chronic kidney disease in autosomal dominant polycystic kidney disease: a single center experience Abdullah Ozkok • Timur Selcuk Akpinar • Fatih Tufan • Nilufer Alpay Kanitez Mukremin Uysal • Metban Guzel • Yasar Caliskan • Sabahat Alisir • Halil Yazici • Tevfik Ecder
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Received: 13 August 2012 / Accepted: 18 September 2012 / Published online: 20 October 2012 Ó Japanese Society of Nephrology 2012
Abstract Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease. The course and progression of the disease is highly variable. In this study, we aimed to investigate the impact of clinical characteristics and basic biochemical parameters on progression of chronic kidney disease (CKD) in ADPKD patients. Materials and methods A total of 323 consecutive patients with ADPKD were enrolled into the study and followed with a mean duration of 100 ± 38 months. Patients were grouped as rapid progressors (RP) and slow progressors (SP) according to median rates of decline in glomerular filtration rate (DGFR) per year, namely 1 ml/ min/year. Results History of macroscopic hematuria, urinary stone and smoking were more common in male patients; hepatic and other organ cysts were more common in female patients. DGFR/year was similar between males and females [0.95 (0–3.02) vs. 1.11 (0.10–2.74) ml/min/year, p = 0.21]. History of smoking and pack-year of cigarettes smoked were significantly higher in the RP compared to the SP group (36 vs. 18 %, p = 0.01 and 5.24 ± 1.20 vs. 3 ± 1.32 pack-year, p = 0.02, respectively). Baseline 24 h-proteinuria was found to be significantly correlated with the percent decline of GFR (D%GFR) per year (r = 0.303, 0.001). In Cox regression analysis for
A. Ozkok T. S. Akpinar F. Tufan N. A. Kanitez M. Uysal M. Guzel Y. Caliskan S. Alisir H. Yazici T. Ecder (&) Department of Internal Medicine and Nephrology, Istanbul Faculty of Medicine, Istanbul University, 34106, Fatih, Istanbul, Turkey e-mail: [email protected]
predicting the progression of CKD, age, hypertension, urinary stone and proteinuria were retained as the significant independent factors predicting progression of CKD in the model. Conclusion Baseline proteinuria was significantly correlated with D%GFR per year. Hypertension and proteinuria were found to be the major treatable risk factors for the progression of CKD in ADPKD patients. Keywords Autosomal dominant polycystic kidney disease Demographics Hypertension Proteinuria Hepatic cyst Urinary stone Angiotensin-converting enzyme inhibitor Angiotensin receptor blocker
Introduction Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease, affecting 1 in 400–1000 individuals [1]. ADPKD is a systemic disorder and may present with various renal and extrarenal manifestations such as hypertension, hematuria, polyuria, urinary tract stones, urinary infections, intracranial aneurysms, mitral valve prolaps
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