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Microalbuminuria in normotensive patients with autosomal-dominant polycystic kidney disease
A Martinez-Vea1, C Gutierrez, A Bardají
1Nephrology Service, Hospital Universitari de Tarragona Joan XXIII, Spain.
Abstract:
Microalbuminuria (MA) is present in hypertensive autosomal-dominant polycystic kidney disease (ADPKD) patients, but has not been reported in normotensive ADPKD patients. We examined the prevalence of MA and the effect of different determinants on urinary albumin excretion in a group of 42 normotensive ADPKD patients. Metabolic parameters, plasma renin activity and aldosterone and serum angiotensin-converting enzyme (ACE) activity were determined. A 24-h urine sample two or three times over a 6-month period was collected to evaluate MA. Each patient underwent an echocardiography to measure left ventricular mass. Eight patients (19%) showed MA (61.6 mg/day, range 37-164), whereas 34 patients (81%) were normoalbuminuric (8.8 mg/day, range 2-29). The groups were matched for all possible confounding variables, but microalbuminuric patients showed a tendency towards greater systolic blood pressure, plasma renin activity and left ventricular mass. There was no correlation between MA and age, sex, body mass index, systolic or diastolic blood pressure, plasma renin activity, serum ACE levels or left ventricular index. The present study demonstrates a high prevalence of MA in normotensive ADPKD patients. MA may be a predictor of early renal and vascular damage in these patients.
Insights
Microalbuminuria (MA) is common in normotensive autosomal-dominant polycystic kidney disease (ADPKD) patients. This finding suggests MA may indicate early kidney and vascular damage in this population.
Area of Science:
- Nephrology
- Cardiology
- Genetics
Background:
- Autosomal-dominant polycystic kidney disease (ADPKD) is a common genetic disorder.
- Microalbuminuria (MA) is a known complication in hypertensive ADPKD patients.
- The prevalence of MA in normotensive ADPKD patients remains understudied.
Purpose of the Study:
- To determine the prevalence of microalbuminuria (MA) in normotensive patients with autosomal-dominant polycystic kidney disease (ADPKD).
- To investigate potential determinants of urinary albumin excretion in this cohort.
- To assess the association between MA and early signs of renal and vascular damage.
Main Methods:
- A cohort of 42 normotensive ADPKD patients was studied.
- Microalbuminuria (MA) was assessed via 24-hour urine samples collected over six months.
- Echocardiography was performed to measure left ventricular mass; metabolic parameters and enzyme activities were also analyzed.
Main Results:
- 19% of normotensive ADPKD patients exhibited microalbuminuria (MA).
- Microalbuminuric patients showed a trend towards higher systolic blood pressure, plasma renin activity, and left ventricular mass.
- No significant correlation was found between MA and age, sex, BMI, blood pressure, or ACE levels.
Conclusions:
- Microalbuminuria (MA) is prevalent in normotensive autosomal-dominant polycystic kidney disease (ADPKD) patients.
- MA may serve as an early indicator of renal and vascular damage in normotensive ADPKD.
- Further research is warranted to elucidate the clinical significance of MA in this population.