Total Kidney Volume, Hypertension, and Deterioration of Kidney Function in Children with Early-Stage ADPKD

Area of Science:

• Pediatric Nephrology
• Medical Imaging Biomarkers
• Polycystic Kidney Disease Research

Background:

• Total kidney volume (TKV) is an emerging non-invasive imaging biomarker for monitoring autosomal dominant polycystic kidney disease (ADPKD) progression in pediatric populations.
• Early detection and monitoring are crucial for managing ADPKD in children to predict disease trajectory.

Purpose of the Study:

• To evaluate the relationship between height-adjusted TKV (htTKV), estimated glomerular filtration rate (GFR), and blood pressure in children with early-stage ADPKD.
• To assess the utility of TKV measurements in predicting GFR decline and hypertension in pediatric ADPKD patients.

Main Methods:

• The study included 72 children with early-stage ADPKD (mean age 12.46 years).
• Measurements included height-adjusted TKV (htTKV), 24-hour ambulatory blood pressure monitoring (ABPM), and estimated GFR.
• Statistical analyses, including correlation and ROC curve analysis, were performed to determine relationships and predictive values.

Main Results:

• Hypertension (HT) was diagnosed in 28% of children, with ABPM identifying previously undiagnosed HT in 16.7%.
• Significantly higher htTKV and TKV z-score were observed in hypertensive children (p=0.018, p=0.020).
• htTKV showed an inverse correlation with GFR (r -0.25, p=0.032), and TKV z-score correlated well with most ABPM parameters. ROC analysis indicated TKV z-score is valuable for predicting GFR decline (AUC 0.808).

Conclusions:

• A significant relationship exists between TKV, GFR, and blood pressure in children with early-stage ADPKD.
• TKV z-score demonstrates utility in predicting GFR decline in pediatric ADPKD.
• Children with ADPKD and increasing TKV warrant close blood pressure monitoring due to associated risks.