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Kidney Week

Abstract: PO1259

A New Ally in Evaluation of Progression of Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Authors

  • Fernandes, Sara, Hospital Beatriz Ângelo, Loures, Portugal
  • Fernandes, Adriana, Hospital Beatriz Ângelo, Loures, Portugal
  • Donato, Beatriz Campos, Hospital Beatriz Ângelo, Loures, Portugal
  • Goncalves, Luis Falcao, Hospital Beatriz Ângelo, Loures, Portugal
  • Raimundo, Mario Rui, Hospital Beatriz Ângelo, Loures, Portugal
  • Teixeira, Catarina, Hospital Beatriz Ângelo, Loures, Portugal
  • de Almeida, Edgar A.F., Hospital Beatriz Ângelo, Loures, Portugal

Group or Team Name

  • Neprhology Department
Background

The available tools for evaluation of progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD) are suboptimal. The study aim is to evaluate the use of urinary glutathione S-transferase (alpha-GST) in predict progression of this disease.

Methods

Prospective, cohort study of ADPKD patients followed on Nephrology clinic. Urinary alpha-GST was normalized to urinary creatinine (U alpha-GST/U Cr), KTV adjusted to height was determined by CT and sequential measures of Scre were done on the following 3 years. The discriminatory ability of U alpha-GST to predict a decline > 30% of eGFR was determined through Sensitivity (S), Specific (SP), Positive Predictive Value (PPV) and Negative Predictive Value (NPP) using as optimal cut-off point the U alfa-GST mean and the ROC curves.

Results

21 patients (61.9% women) were included, mean age of 45,0 (IQR 19) years. Initial Scre was 0,98 (IQR 0,64) mg/dL, KTV was 1079 (IQR 1543) mL and U alpha-GST/ U Cr was 6,88 (IQR 6,88) ug/g. U alpha-GST/ U Cr positive correlated with initial Scr (rs 0,614; p=0,002) and latest Scr (rs 0,622, p=0,003). There wasn’t a significant statistical correlation between U alpha- GST/ U Cr and the percent decline of eGFR (rs 0,043, p=0,07). U alpha-GST/ U Cr demonstrated S of 71%, SP of 64%, PPV of 50% and NPV of 82% to identify patients with a decline >30% of eGFR over a 3 year period. On ROC curves,U alpha- GST/ U Cr and KVT showed a fair ability to predict a decline >30% of eGFR (AuROC 0,704 e 0,735, respectively), but when used together, the discriminatory ability significatively improve (AuROC 0,833 for the U alpha- GST/ U Cr x KVT variable).

Conclusion

Although, the small size population is limitation of the study, the ability to predict disease progression was improved through the use of KVT and urinary biomarker variable. Larger studies are need to validate its use.