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Urinary Citrate Is Associated with Kidney Outcomes in Early Polycystic Kidney Disease

Daniel Ribeiro Rocha1, Laixi Xue2, Hiago Murilo Gomes Sousa1

  • 1Division of Nephrology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

Kidney360
|January 2, 2023
PubMed

Insights

Low urinary citrate levels accelerate cyst growth in polycystic kidney disease (PKD). This finding suggests that monitoring citrate may help predict disease progression and improve kidney survival in patients with autosomal dominant PKD.

Area of Science:

  • Nephrology
  • Urology
  • Biochemistry

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic kidney disorder.
  • Hypocitraturia (low urinary citrate) is frequently observed in ADPKD patients.
  • Citrate plays a role in inhibiting calcium crystal formation.

Purpose of the Study:

  • To investigate the role of low urinary citrate in the progression of polycystic kidney disease (PKD).
  • To determine the association between hypocitraturia and cystogenesis in an experimental PKD model.
  • To explore the relationship between early hypocitraturia and clinical outcomes in PKD.

Main Methods:

  • Utilized an experimental model of polycystic kidney disease.
  • Assessed urinary citrate levels and crystal deposition.
  • Monitored cystogenesis and estimated glomerular filtration rate (eGFR) decline.
  • Correlated urinary citrate with kidney survival rates.

Main Results:

  • Low urinary citrate and crystal deposition were found to accelerate cystogenesis in the experimental PKD model.
  • Lower urinary citrate levels in early PKD were associated with a faster decline in eGFR.
  • Reduced urinary citrate correlated with worse kidney survival outcomes.

Conclusions:

  • Hypocitraturia may be a significant factor contributing to the progression of autosomal dominant polycystic kidney disease (ADPKD).
  • Urinary citrate levels could serve as a potential biomarker for disease severity and prognosis in PKD.
  • Targeting urinary citrate levels may offer a therapeutic strategy for managing PKD progression.

Keywords:
ADPKDCKDcystic kidney diseaseeGFRpolycystic kidney diseaseurinary citrate

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