Kidney Week

Abstract: TH-PO857

Systemic Endothelial Function Is Associated with Renal Disease Severity in Early Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Session Information

• Cystic Kidney Diseases: Clinical
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1001 Genetic Diseases of the Kidneys: Cystic

Authors

• Tug, Ali Y., Mayo Clinic, Rochester, Minnesota, United States

Ali Y. Tug,

• Elsekaily, Walaa, Mayo Clinic, Rochester, Minnesota, United States

Walaa Elsekaily,

• Leistikow, Kathleen, Mayo Clinic, Rochester, Minnesota, United States

Kathleen Leistikow,

• Chebib, Fouad T., Mayo Clinic, Rochester, Minnesota, United States

Fouad T. Chebib,

• Harris, Peter C., Mayo Clinic, Rochester, Minnesota, United States

Peter C. Harris,

• Rodriguez- Porcel, Martin G., Mayo Clinic, Rochester, Minnesota, United States

Martin G. Rodriguez- Porcel,

• Yu, Alan S.L., University of Kansas Medical Center, Kansas City, Kansas, United States

Alan S.L. Yu,

• Lerman, Lilach O., Mayo Clinic, Rochester, Minnesota, United States

Lilach O. Lerman,

• Lerman, Amir, Mayo Clinic, Rochester, Minnesota, United States

Amir Lerman,

• Torres, Vicente E., Mayo Clinic, Rochester, Minnesota, United States

Vicente E. Torres,

• Irazabal, Maria V., Mayo Clinic, Rochester, Minnesota, United States

Maria V. Irazabal,

Background

In vitro studies have shown impaired endothelium-dependent relaxation of small resistance vessels in patients with ADPKD. Peripheral-arterial tonometry (PAT) provides, with high reproducibility and no operator dependency, non-invasive measures of nitric oxide-mediated endothelial response. However, no study has evaluated endothelial function by PAT in patients with ADPKD. This pilot study tested the hypothesis that systemic endothelial dysfunction, as determined by PAT, would be detectable prior to development of hypertension and would correlate with renal disease severity determined by height adjusted total kidney volume (htTKV) in patients with ADPKD.

Methods

Twelve young (18-40 years), early stage (eGFR>90 mL/min/1.73 m²), normotensive (without blood pressure medication) patients with ADPKD and age/sex matched controls (2:1), underwent medical questionnaire, blood and urine collection, abdominal MRI for TKV and renal blood flow (RBF), and PAT for reactive hyperemia index (RHI, normal value ≥2) determination.

Results

Main clinical and laboratory characteristics are shown in table 1. ADPKD patients presented with abnormal RHI levels, which correlated inversely with htTKV (R²=0.394, p=0.039), and directly with RBF (R²=0.485, p=0.017). There was no correlation between RHI, htTKV, or RBF and eGFR or other parameters listed in table 1.

Conclusion

Systemic endothelial dysfunction as determined by PAT may be an early marker of vascular changes in patients with ADPKD, and is associated with renal disease severity. These observations may suggest systemic endothelial function as a diagnostic and therapeutic target in patients with ADPKD.

Funding

• NIDDK Support