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Abstract: TH-PO400

Evaluation of Advanced MRI Cystic Biomarkers at Kidney Failure in Patients With Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1101 Genetic Diseases of the Kidneys: Cystic

Authors

  • Wigerinck, Stijn, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Chedid, Maroun, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Gregory, Adriana, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kaidbay, Hasan-Daniel Nabil, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Hanna, Christian, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Senum, Sarah R., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Harris, Peter C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kline, Timothy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Chebib, Fouad T., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Group or Team Name

  • PKD Center Mayo Clinic Rochester
Background

Height-adjusted total kidney volume, a surrogate of cystic expansion, is associated with decline in GFR. In a recent cohort of patients with ADPKD who reached end stage kidney failure (ESKD), HtTKV at ESKD was 12.3% smaller with each decade of age. This raised the question about the contribution of non-cystic volume to the worsening of kidney function in older patients. We aimed to assess various imaging biomarkers to understand the characteristics of the ADPKD kidneys at ESKD

Methods

This is a retrospective cross-sectional study of patients with ADPKD with ESKD evaluated at Mayo Clinic with available MRI imaging and genotype (N=50, 11 excluded due to incomplete MR coverage,1 with NMD). Using an automated instance cyst segmentation algorithm, we obtained the following imaging parameters: HtTKV, Mayo Imaging Class (MIC), cyst number, total cystic volume (TCV), cyst index (TCV/TKV), cyst parenchyma surface area (CPSA), and total parenchymal volume (TPV).

Results

Thirty-nine patients were divided in 3 groups based on age at ESKD (<46, 46-56 and >56 yo) (Table). Baseline characteristics and ADPKD genotype are shown in table. Most patients in groups 1 and 2 were MIC1D-1E and most patients in group 3 were MIC1B-1C (P<0.01). Cyst index at ESKD was similar at all ages. Age correlated weakly (P<0.01) with HtTKV, cyst number, CSA, CPSA, and cyst index (R2 0.01, 0.01, 0.01, 0.02, and 0.03 respectively) and negatively with TPV (R2 0.1). HtTKV correlated (P<0.01) positively with cyst number, TCV, CPSA and TPV (R2 0.30, 0.95, 0.90 and 0.67, respectively).

Conclusion

The lower TPV in older patients and the negative correlation between age and TPV are consistent with the hypothesis that vascular changes and fibrosis are important determinants of GFR decline in older patients. HtTKV at ESKD correlated positively with cyst number, TCV, TPV CPSA. Cyst index at ESKD was similar at all ages.