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Abstract: TH-PO392

Altitude, Resting Metabolic Rate, and Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1101 Genetic Diseases of the Kidneys: Cystic

Authors

  • Steele, Cortney, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Coleman, Erin R., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Struemph, Taylor, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • George, Diana, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Winslow, Claire Winslow H., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Gitomer, Berenice Y., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Chonchol, Michel, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Nowak, Kristen L., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most commonly inherited progressive kidney disease and is known to alter metabolic pathways and influence mitochondrial energy production, which in turn could modulate resting metabolic rate (RMR). Acute altitude exposure may influence RMR in those with ADPKD, however, data are lacking.

Methods

ADPKD patients were enrolled in clinical trials at the University of Colorado Anschutz Medical Campus. RMR assessments were performed at baseline in Aurora, CO (elevation 5,403′) via indirect calorimetry. Living elevation was determined by city and state of residence. Participants were stratified into those living at low altitudes (<4,000’) and those living at high altitudes (≥4,000’). RMR equations Harris-Benedict (H-B) and Mifflin-St Jeor (M) were calculated. In a subset of participants, height adjusted-total kidney volume (htTKV) was measured via magnetic resonance imaging (MRI) as an indicator of disease severity. Independent t-tests were used to determine differences between those living at low/high altitudes. Analysis of covariance and linear regression analyses were also performed.

Results

Baseline characteristics of 64 participants were included (42 females (F), 46±10 yrs of age (mean±s.d.), body mass index (BMI) 32.3±5 kg/m2, and RMR 1721± 289 kcal/day). Those living at <4,000’ and ≥4,000’ elevation had similar baseline characteristics (p>0.05). After adjusting for age, sex, and BMI, those living at low altitudes tended to have a higher RMR when measured at high altitude than those living at high altitudes (p=0.09). Percent differences between indirect calorimetry and prediction equations (H-B and M) were greater in those living at low altitudes performing the RMR assessment at altitude (p<0.05). Only a subset of participants had calculated htTKV values (n=22, 11 F, 46±10 yrs of age, BMI 33.9±5 kg/m2, and RMR1809±239 kcal/day). Increasing RMR was associated with an increase in htTKV (r=0.50, p=0.02); the association remained after adjusting for BMI (r=0.46, p=0.04).

Conclusion

In ADPKD patients living at low altitudes, altitude exposure appeared to elevate RMR when compared to those living at high altitude. Higher RMR may be associated with greater disease severity. Further research is needed to confirm these preliminary data.

Funding

  • NIDDK Support