scholarly journals Cardiac involvement in patients with Autosomal Dominant Polycystic Kidney Disease and normal renal function after six years of follow-up

2021 ◽  
Vol 75 ◽  
pp. 502-510
Author(s):  
Maria Pietrzak-Nowacka ◽  
Krzysztof Safranow ◽  
Małgorzata Czechowska ◽  
Grażyna Dutkiewicz ◽  
Ewa Gątarska ◽  
...  

The aim of the follow-up study was to compare the changes of M-mode echocardiographic parameters in autosomal dominant polycystic kidney disease (ADPKD) patients and controls without renal failure during six years of observation and to explore the associations of these parameters with metabolic syndrome components and kidney function. We performed a follow-up examination in 37 ADPKD patients and 40 controls. Anthropometric parameters were measured and fasting venous blood sample from each patient was tested for glucose, insulin, C-peptide, HbA1c, creatinine, and urea concentrations. All subjects underwent standard two-dimensional M-mode echocardiography. Left ventricular hypertrophy (LVH) was diagnosed based on left ventricular mass index (LVMI) adjusted for body surface area (LVMI- -S, LVH-S) or for height (LVMI-H, LVH-H). The prevalence of LVH was significantly greater in ADPKD patients than in controls (35% vs. 10%, p=0.012) according to the ESH/ESC criteria from 2013, and (27.0% vs. 7.5%, p=0.032) according to criteria from 2017. In patients with ADPKD, no significant increase of the echocardiographic parameters was observed in the 6 years between the initial examination and the follow-up examination. Cardiac involvement in women with ADPKD occurs at an earlier stage of the disease than in men. In patients with ADPKD treated for hypertension in accordance with the 2013 ESH/ESC Guidelines the progression of LVH was not observed during the 6-year follow-up, despite the deterioration of renal function. Obesity, blood pressure and renal function do not affect LVMI changes.

2021 ◽  
Vol 11 (2) ◽  
pp. 39-49
Author(s):  
Letizia Spinelli ◽  
Giuseppe Giugliano ◽  
Giovanni Esposito

Cardiovascular disorders are the main complication in autosomal dominant polycystic kidney disease (ADPKD). contributing to both morbidity and mortality. This review considers clinical studies unveiling cardiovascular features in patients with ADPKD. Additionally, it focuses on basic science studies addressing the dysfunction of the polycystin proteins located in the cardiovascular system as a contributing factor to cardiovascular abnormalities. In particular, the effects of polycystin proteins’ deficiency on the cardiomyocyte function have been considered.


2016 ◽  
Vol 44 (3) ◽  
pp. 171-178 ◽  
Author(s):  
Kristen L. Nowak ◽  
Melissa A. Cadnapaphornchai ◽  
Michel B. Chonchol ◽  
Robert W. Schrier ◽  
Berenice Gitomer

Background: Long-term clinical outcomes in children with very-early onset (VEO; diagnosis in utero or within the first 18 months of life) autosomal dominant polycystic kidney disease (ADPKD) are currently not well understood. We conducted a longitudinal retrospective cohort study to assess the association between VEO status and adverse clinical outcomes. Methods: Seventy patients with VEO-ADPKD matched (by year of birth, sex and race/ethnicity) to 70 patients with non-VEO-ADPKD who participated in research at the University of Colorado were studied. Kaplan-Meier survival analysis was performed. The predictor was VEO status, and outcomes were progression to end-stage renal disease (ESRD), development of hypertension, progression to estimated glomerular filtration rate (eGFR <90 ml/min/1.73 m2), glomerular hyperfiltration (eGFR ≥140 ml/min/1.73 m2) and height-adjusted total kidney volume (htTKV) measured by MRI ≥600 ml/m. Results: Median follow-up was until 16.0 years of age. There were only 4 ESRD events during the follow-up period, all in the VEO group (p < 0.05). VEO patients were more likely to develop hypertension (hazard ratio, HR 3.15, 95% CI 1.86-5.34; p < 0.0001) and to progress to eGFR <90 ml/min/1.73 m2 (HR 1.97, 95% CI 1.01-3.84; p < 0.05) than non-VEO patients. There was no difference between groups in the development of glomerular hyperfiltration (HR 0.89, 95% CI 0.56-1.42; p = 0.62). There were only 7 patients who progressed to htTKV ≥600 ml/m, 4 in the VEO group and 3 in the non-VEO group (p < 0.01). Conclusions: Several clinical outcomes are worse in patients with VEO-ADPKD compared to non-VEO ADPKD. Children with VEO-ADPKD represent a particularly high-risk group of ADPKD patients.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chang Seong Kim ◽  
Hong Sang Choi ◽  
Eun hui Bae ◽  
Seong Kwon Ma ◽  
Soo Wan Kim

Abstract Background and Aims Overweight or obese patients with autosomal dominant polycystic kidney disease (ADPKD) are associated with the decline of glomerular filtration rate. However, little is known about the annual rate of change in total kidney volume (TKV) in patients with ADPKD according to the body mass index (BMI) corrected by TKV and total liver volume (TLV). Method We analyzed 364 patients with ADPKD from the KoreaN Cohort Study for Outcomes in Patients with Chronic Kidney Disease. We compared the changes in TKV in less than 1-year, 2-years and 4-year follow-up from patients by dividing baseline body mass index (BMI) by 18.5 to 22.9 (normal), 23 to 24.9 (overweight), and &gt; 25 kg/m2 (obesity). Results During the 4-year follow-up period, TKV tended to increase statistically with increasing BMI (P = 0.032). Similarly, higher BMI group showed higher TKV than lower BMI group (P = 0.016). Conventional BMI is affected by TKV and TLV in advanced ADPKD patients. Therefore, we reclassified patients by corrected BMI using the adjusted body weight (body weight – TKV – TLV). Although the statistical significances between absolute value of TKV and corrected BMI groups were disappeared during the follow-up, TKV% change/year showed significantly higher in ADPKD patients with obesity among corrected BMI groups (normal; 20.2%, overweight; 17.6% and obesity; 30.6%, P for trend = 0.022) Conclusion Even after correcting the TKV and TVL, obese patients showed a high of TKV% change/year compared to non-obese patients with ADPKD.


Sign in / Sign up

Export Citation Format

Share Document