The Role of Adiposity and Anthropometrics on Disease Progression in Autosomal Dominant Polycystic Kidney Disease: A Narrative Review.

Abstract

Purpose of review: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by numerous cysts in kidneys and other organs which enlarge and cause organ dysfunction, with kidney involvement being the most common. Recently, increased body mass index, and adiposity have been associated with disease progression. In this review, we summarized the available literature on anthropometrics (body mass index, waist circumference, weight to hip ratio and visceral adipose tissue and their relationship with ADPKD progression.

Recent findings: Although the mechanisms are not clear, various pathological processes and signaling pathways are aberrantly activated with increased adiposity in patients with ADPKD. These alterations may result in glomerular hyperfiltration, chronic inflammation, aberrant signaling, and metabolic alterations which cause disease progression in ADPKD. Although increased adiposity may be associated with ADPKD progression, the best anthropometric parameter related to disease progression is not known. Losing weight in overweight and obese individuals with ADPKD is probably beneficial but the type of diet (daily caloric restriction, intermittent fasting etc.) that is most effective needs to be clarified. Moreover, caution is warranted during weight loss, as caloric restriction may cause malnutrition.