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[Study of prognostic factors for renal function in patients with autosomal dominant polycystic kidney disease]
Insights
Autosomal dominant polycystic kidney disease (ADPKD) often presents with hematuria and hypertension, with many patients experiencing renal function decline at diagnosis. Residual renal parenchyma volume and PSP120/sCr ratio are key prognostic factors.
Area of Science:
- Nephrology
- Genetics
- Internal Medicine
Context:
- Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder.
- Understanding clinical features and prognostic factors is crucial for patient management.
Purpose:
- To investigate clinical characteristics and identify prognostic factors for renal function in ADPKD patients.
- To correlate imaging findings and biochemical markers with disease progression.
Summary:
- A cohort of 118 ADPKD patients (60 male, 58 female) were followed for a mean of 77 months.
- Hematuria, hypertension, and proteinuria were common symptoms. Renal function deterioration was observed in 41% at diagnosis.
- Residual renal parenchyma volume on CT and the PSP120/sCr ratio were significant prognostic indicators. Men experienced hemodialysis initiation at younger ages than women. Hypertension negatively impacted renal function.
Impact:
- Identifies key indicators for predicting renal function decline in ADPKD.
- Provides insights into disease progression and timing for interventions like dialysis.
- Highlights gender-based differences in disease progression and the detrimental effect of hypertension.
Abstract:
To examine clinical features and the prognostic factors for renal function in patients with autosomal dominant polycystic kidney disease (ADPKD), a total of 118 patients (60 men and 58 women) were followed for 3 to 192 months (mean 77 months). The mean age of men at the diagnosis of ADPKD was younger than that of women. Main Symptoms were hematuria, hypertension and proteinuria. Forty-one % of the patients showed deterioration of renal function at the diagnosis. The rate of residual volume of renal parenchyma on CT findings was correlated well with renal function. Twenty-eight % of the patients preserved good and stable renal functions for over 5 years, while most of others had deterioration in their renal function. Thirty-four % of the patients started dialysis within 79 +/- 62 months from the diagnosis. The frequency of end stage renal failure was 7% at 40 years, 21% at 50 years, 36% at 60 years and 63% at 70 years old, respectively. Men needed hemodialysis at younger ages than women. Renal function of the patients with hypertension was worse than that of the patients without hypertension. The ratio of the value of P.S.P.120 to that of serum creatinine (PSP120/sCr), and the rate of residual volume of renal parenchyma revealed distinct prognostic factors for renal function.