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Abstract: TH-PO851

Association Between Baseline Renal Blood Flow and CKD Progression in Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Authors

  • Torres, Vicente E., Mayo Clinic, Rochester, Minnesota, United States
  • Shi, Tiange, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Landsittel, Doug, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Bae, Kyongtae Ty, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Tao, Cheng, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Yu, Alan S.L., University of Kansas Medical Center, Kansas City, Kansas, United States
  • Chapman, Arlene B., University of Chicago, Chicago, Illinois, United States
  • Mrug, Michal, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Rahbari-Oskoui, Frederic F., Emory University School of Medicine, Atlanta, Georgia, United States
  • Harris, Peter C., Mayo Clinic, Rochester, Minnesota, United States

Group or Team Name

  • Consortium for Radiological Imaging Studies of Polycystic Kidney Disease
Background

Previous Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) studies have shown height-adjusted total kidney volume (htTKV) and renal blood flow (RBF) were independent predictors of renal disease progression. Here we describe an extended study to identify and evaluate the prognostic value of baseline RBF in ADPKD.

Methods

Linear mixed models were utilized to model the effect of baseline RBF on changes in GFR over time adjusting for baseline variables (age, htTKV, gender, mean arterial pressure, hypertension status, genotype, serum HDL cholesterol, serum LDL cholesterol, filtration fraction and protein intake) and (1) either urine albumin, sodium or phosphorus excretions and (2) either BSA or BMI. Logistic regression models were applied to predict CKD using baseline RBF adjusting for baseline age and htTKV. Likelihood ratio tests were conducted to assess the significance of the variables. Area under ROC curve (AUROC) were calculated to assess the models’ prognosis ability for reaching CKD outcomes (stage 3A, 3B or 4).

Results

Higher baseline RBF is significantly (p<0.001) associated with higher GFR in ADPKD patients over time when adjusting for the baseline variables: (1) either urine albumin, sodium or phosphorus excretions and (2) either BSA or BMI. Baseline RBF is a strong independent predictor of CKD outcomes in both an unadjusted logistic model (p<0.001; AUROCs, from 0.75 to 0.78), or after adjustment for baseline age (p<0.01; AUROCs, 0.82 to 0.85), with similar results across CKD stages 3A, 3B or 4. The combination of baseline RBF and htTKV showed strong prognosis value for CKD outcomes after adjustment for baseline age (AUROCs, from 0.90 to 0.91).

Conclusion

Baseline RBF is a strong independent prognostic marker for renal disease progression in ADPKD. Renal blood flow could be used as a prognostic and potentially monitoring biomarker in this disease.

Funding

  • NIDDK Support