Predictors of progression to end-stage renal disease among patients with polycystic kidney disease type 1 in Alexandria Governorate Egypt

Abstract

Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of end-stage kidney disease (ESRD). Owing to the delay between onset of diagnosing the disease and renal outcome, the study of renal progression raises unique challenges in these patients. The aim of this study is to identify predictors of progression to ESRD among patients with a PCR-confirmed ADPKD-1. Material and methods The study population comprised patients with a PCR-confirmed ADPKD-1 between May 2019 and August 2022. Patients were distributed into two groups: Group I: 35 ADPKD-1 patients not receiving renal replacement therapy ( RRT) and Group II: 65 ADPKD-1 patients receiving RRT. Socio-demographic characteristics, smoking ,age at diagnosis , onset of hypertension, initiation of RRT, recurrent hematuria, and urinary tract infection were reported. Serum uric acid , and ultrasonography were done. Results No significant difference between the two groups regarding sex, family history of ADPKD-1, and time to develop hypertension. On the other hand, significantly higher percentage of group (II) patients were smokers compared with group (I). Recurrent hematuria and UTI were more prevalent among group (II) compared to group (I), the mean age at diagnosis of hypertension was significantly lower in group (II), the mean serum uric acid level was significantly higher in group (II). Moreover, significantly higher percentage of group (II) patients had two or more liver cysts. Conclusion Progression of ADPKD can be affected by several factors, including hypertension, hyperuricemia, hematuria, and UTI. Modification these factors may decrease the rate of the deterioration of renal function.