Kidney Week

Abstract: SA-PO504

Arterial stiffness Is Independently Associated with Total Kidney Volume in Children and Young Adults with ADPKD

Session Information

• ADPKD: Clinical Studies
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

• 1001 Genetic Diseases of the Kidney: Cystic

Authors

• Nowak, Kristen L., University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak,

• Malaczewski, Mikaela R., University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States

Mikaela R. Malaczewski,

• Gitomer, Berenice Y., University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States

Berenice Y. Gitomer,

• George, Diana, University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States

Diana George,

• Chonchol, Michel, University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States

Michel Chonchol,

Background

Large-elastic artery stiffness is independently associated with both impaired kidney function and future decline in estimated glomerular filtration rate (eGFR) in chronic kidney disease. In patients with autosomal dominant polycystic kidney disease (ADPKD), an increase in total kidney volume (TKV) precedes the decline in kidney function and is a prognostic marker of future kidney function decline. We hypothesized that large-elastic artery stiffness, measured as carotid-femoral pulse-wave velocity (CFPWV), would be independently associated with height-adjusted TKV (htTKV) in children and young adults with ADPKD and preserved kidney function.

Methods

51 non-diabetic children and young adults (6-25 years) with ADPKD and eGFR >90 ml/min/1.73m² with baseline data from an ongoing clinical trial underwent measurement of CFPWV and htTKV (by magnetic resonance imaging). The cross-sectional association of CFPWV with htTKV was evaluated using multiple linear regression models.

Results

Mean+s.d. age was 19±5 years, median htTKV was 371 (274, 509) ml/mm, and median CFPWV was 515 (455, 569) cm/sec. htTKV was greater in participants with CFPWV above the median (455 [308, 969] ml/m) compared to below the median (309 [267, 397] ml/m; p<0.0001). After adjustment for age, sex, race/ethnicity, systolic blood pressure, eGFR, and overweight/obesity, greater CFPWV was associated with larger htTKV (β-estimate: 11.27; 95% Confidence Interval: 1.0, 21.6, per 10 unit increase in CFPWV; p<0.05).

Conclusion

In children and young adults with ADPKD, CFPWV is independently associated with increased htTKV, an important predictor of progression in early-stage disease. Targeting arterial stiffness may be a novel strategy to slow kidney growth in children and young adults with ADPKD.

Funding

• NIDDK Support