Association of Kidney Volume With Patient-Reported Outcomes in ADPKD

Area of Science:

• Nephrology
• Genetics
• Quality of Life Research

Background:

• Autosomal dominant polycystic kidney disease (ADPKD) causes significant physical and emotional distress, often linked to enlarged kidneys.
• The relationship between health-related quality of life (HRQOL) and total kidney volume (TKV) in ADPKD patients, considering kidney function and pain, requires further clarification.

Purpose of the Study:

• To investigate the association between TKV, kidney function (eGFR), and chronic kidney pain with HRQOL in ADPKD patients.
• To identify patient clusters based on ADPKD severity and pain status and compare their HRQOL outcomes.

Main Methods:

• Multivariable linear regression was used to analyze associations between TKV, eGFR, kidney pain, and SF-36 HRQOL scores in 456 ADPKD participants.
• Factor analysis of mixed data (FAMD) was employed to classify patients into distinct clusters based on TKV, eGFR, and pain, followed by HRQOL comparisons.

Main Results:

• Increasing TKV tertiles were associated with decreased physical component summary (PCS) scores, independent of kidney function and pain (P=0.02).
• Lower eGFR and the presence of kidney pain were linked to worse overall HRQOL.
• Four patient clusters were identified, with the 'high ADPKD severity, kidney pain' cluster exhibiting the most impaired PCS and MCS scores. TKV indirectly affected mental component summary (MCS) via kidney pain.

Conclusions:

• TKV is a significant determinant of physical health in ADPKD, irrespective of kidney function and pain.
• Kidney pain acts as a mediator between TKV and mental health in ADPKD patients.
• Interventions targeting kidney pain reduction, function preservation, and limiting kidney enlargement are crucial for improving HRQOL in ADPKD.