Kidney growth progression patterns in autosomal dominant polycystic kidney disease

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Aaron Pérez-Segovia , Gabriel Cojuc-Konigsberg , Estefania Reul-Linares , Elisa Naomi Hernández-Paredes , Mónica Chapa-Ibargüengoitia , Juan C. Ramírez-Sandoval
{"title":"Kidney growth progression patterns in autosomal dominant polycystic kidney disease","authors":"Aaron Pérez-Segovia ,&nbsp;Gabriel Cojuc-Konigsberg ,&nbsp;Estefania Reul-Linares ,&nbsp;Elisa Naomi Hernández-Paredes ,&nbsp;Mónica Chapa-Ibargüengoitia ,&nbsp;Juan C. Ramírez-Sandoval","doi":"10.1016/j.arcmed.2024.103099","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Prognosis for autosomal dominant polycystic kidney disease (ADPKD), the main inherited cause of kidney failure, relies on estimating cystic growth using linear formulas derived from height-adjusted total kidney volume (Ht-TKV). However, nonlinear renal growth patterns may occur in typical ADPKD.</div></div><div><h3>Aims</h3><div>To determine kidney outcomes of subjects diagnosed with typical ADPKD exhibiting nonlinear, and unpredictable cystic growth during follow-up.</div></div><div><h3>Methods</h3><div>Retrospective cohort study. We categorized TKV changes in individuals with typical ADPKD according to observed kidney growth trajectories. Ht-TKV was calculated from consecutive CT or MRI using the ellipsoid method. We compared estimated glomerular filtration rate (eGFR) trajectories with linear mixed models.</div></div><div><h3>Results</h3><div>We included 83 individuals with ADPKD (67% women; age 47 ± 12 years; follow-up 5.2 years [IQR 2.8–9.0]). Three kidney growth patterns were observed: slow progression (24%, &lt;3%/year linear increase), fast progression (39%, ≥3%/year linear increase), and atypical progression (37%, nonlinear growth). Adjusted ht-TKV change in mL/m/year was +1.4 (IQR –4.5 to +10.0), +40.3 (+16.9 to +89.3), and +32.8 (+15.9 to +85.9) for slow, fast, and atypical progressors, respectively (<em>p</em> &lt; 0.001). Atypical progressors exhibited a significantly greater decline in eGFR in mL/min/m²/year (–7.9, 95% CI –6.5, –3.9) compared to slow (–0.5, 95% CI –3.1 to +0.5) and fast progressors (–3.4, 95% CI –7.9, –2.0; between-group <em>p</em> &lt; 0.001). Atypical progressors had a higher proportion of acute complications, including hemorrhages, infections, and urolithiasis (84%), compared to slow (20%) and fast progressors (31%) (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In typical ADPKD, nonlinear, abrupt, and unpredictable cyst growth occurs frequently, leading to a higher risk of acute complications and kidney function decline.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 2","pages":"Article 103099"},"PeriodicalIF":4.7000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0188440924001504","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Prognosis for autosomal dominant polycystic kidney disease (ADPKD), the main inherited cause of kidney failure, relies on estimating cystic growth using linear formulas derived from height-adjusted total kidney volume (Ht-TKV). However, nonlinear renal growth patterns may occur in typical ADPKD.

Aims

To determine kidney outcomes of subjects diagnosed with typical ADPKD exhibiting nonlinear, and unpredictable cystic growth during follow-up.

Methods

Retrospective cohort study. We categorized TKV changes in individuals with typical ADPKD according to observed kidney growth trajectories. Ht-TKV was calculated from consecutive CT or MRI using the ellipsoid method. We compared estimated glomerular filtration rate (eGFR) trajectories with linear mixed models.

Results

We included 83 individuals with ADPKD (67% women; age 47 ± 12 years; follow-up 5.2 years [IQR 2.8–9.0]). Three kidney growth patterns were observed: slow progression (24%, <3%/year linear increase), fast progression (39%, ≥3%/year linear increase), and atypical progression (37%, nonlinear growth). Adjusted ht-TKV change in mL/m/year was +1.4 (IQR –4.5 to +10.0), +40.3 (+16.9 to +89.3), and +32.8 (+15.9 to +85.9) for slow, fast, and atypical progressors, respectively (p < 0.001). Atypical progressors exhibited a significantly greater decline in eGFR in mL/min/m²/year (–7.9, 95% CI –6.5, –3.9) compared to slow (–0.5, 95% CI –3.1 to +0.5) and fast progressors (–3.4, 95% CI –7.9, –2.0; between-group p < 0.001). Atypical progressors had a higher proportion of acute complications, including hemorrhages, infections, and urolithiasis (84%), compared to slow (20%) and fast progressors (31%) (p < 0.001).

Conclusion

In typical ADPKD, nonlinear, abrupt, and unpredictable cyst growth occurs frequently, leading to a higher risk of acute complications and kidney function decline.
常染色体显性多囊肾的肾脏发育模式
背景:常染色体显性多囊肾病(ADPKD)是导致肾衰竭的主要遗传性疾病,其预后依赖于根据身高调整肾脏总体积(Ht-TKV)得出的线性公式来估计囊肿的生长情况。然而,在典型的 ADPKD 中可能会出现非线性的肾脏生长模式。目的:确定被诊断为典型 ADPKD 的受试者在随访期间表现出非线性和不可预测的囊性生长的肾脏预后:方法:回顾性队列研究。我们根据观察到的肾脏生长轨迹对典型 ADPKD 患者的 TKV 变化进行了分类。Ht-TKV采用椭圆体法从连续CT或MRI中计算得出。我们用线性混合模型比较了估计的肾小球滤过率(eGFR)轨迹:我们纳入了 83 名 ADPKD 患者(67% 为女性;年龄 47 ± 12 岁;随访 5.2 年 [IQR 2.8-9.0])。观察到三种肾脏生长模式:进展缓慢(24%,结论:在典型的 ADPKD 患者中,非肾脏生长模式的肾脏生长速度较慢:在典型的 ADPKD 中,非线性、突发性和不可预测的囊肿生长经常发生,导致急性并发症和肾功能下降的风险较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信