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Published on: June 23, 2015
Evaluation of advanced imaging biomarkers at kidney failure in patients with ADPKD: a pilot study
Stijn Wigerinck1,2, Adriana V Gregory3, Byron H Smith4
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Insights
Advanced imaging reveals age-related differences in autosomal dominant polycystic kidney disease (ADPKD) progression. Younger patients show higher cystic burden, while older patients have less kidney volume at kidney failure.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) exhibits variable disease severity and progression.
- Advanced imaging biomarkers offer insights into cystic and non-cystic processes contributing to kidney failure across different age demographics.
Purpose of the Study:
- To investigate age-related differences in advanced imaging biomarkers in patients with ADPKD and kidney failure.
- To compare these biomarkers with those in early chronic kidney disease (CKD) stages.
Main Methods:
- A pilot study involved 39 ADPKD patients with kidney failure, divided into three age groups (<46, 46-56, >56 years).
- Automated instance cyst segmentation was used to assess advanced imaging biomarkers.
- Biomarkers were compared to an age- and sex-matched ADPKD cohort in early CKD.
Main Results:
- Total parenchymal volume correlated negatively with age at kidney failure, being lower in patients over 56.
- Cystic burden was higher in patients reaching kidney failure before age 46.
- Cyst index remained comparable across age groups and Mayo Imaging Classes at kidney failure.
Conclusions:
- Age-related variations in advanced imaging biomarkers suggest diverse pathophysiological mechanisms in ADPKD.
- Further research is needed to validate these biomarkers for predicting disease progression and guiding treatment.
Background:
Autosomal dominant polycystic kidney disease (ADPKD) presents with variable disease severity and progression. Advanced imaging biomarkers may provide insights into cystic and non-cystic processes leading to kidney failure in different age groups.
Methods:
This pilot study included 39 ADPKD patients with kidney failure, stratified into three age groups (<46, 46-56, >56 years old). Advanced imaging biomarkers were assessed using an automated instance cyst segmentation tool. The biomarkers were compared with an age- and sex-matched ADPKD cohort in early chronic kidney disease (CKD).
Results:
Ht-total parenchymal volume correlated negatively with age at kidney failure. The median Ht-total parenchymal volume was significantly lower in patients older than 56 years. Cystic burden was significantly higher at time of kidney failure, especially in patients who reached it before age 46 years. The cyst index at kidney failure was comparable across age groups and Mayo Imaging Classes. Advanced imaging biomarkers showed higher correlation with Ht-total kidney volume in early CKD than at kidney failure. Cyst index and parenchymal index were relatively stable over 5 years prior to kidney failure, whereas Ht-total cyst volume and cyst parenchymal surface area increased significantly.
Conclusion:
Age-related differences in advanced imaging biomarkers suggest variable pathophysiological mechanisms in ADPKD patients with kidney failure. Further studies are needed to validate the utility of these biomarkers in predicting disease progression and guiding treatment strategies.
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