Abstract: TH-PO388
Parameters Associated With Progression, Prognosis, and Tolvaptan Indication in Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Session Information
- Genetic Diseases of the Kidneys: Cystic - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1101 Genetic Diseases of the Kidneys: Cystic
Authors
- Gkika, Vasiliki, Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
- Louka, Michaela, Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
- Tigka, Eirini, Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
- Drakopoulos, Angelos, Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
- Kostopoulou, Myrto, Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
- Tsirpanlis, George I., Department of Nephrology, General Hospital of Athens "G. Gennimatas”, Athens, Greece
Background
The identification of possible risk factors for the progression of ADPKD is an emerging field, especially after the introduction of tolvaptan as the first disease-specific treatment. This study aims to explore the associations between epidemiological, clinical, and imaging data in a large cohort of ADPKD patients.
Methods
This study was from a single ADPKD outpatient clinic and were included patients with a recent Magnetic Resonance Imaging (MRI) for the measurement of Total Kidney Volume (TKV). For all patients, the Mayo Clinic Imagining Category (MCIC) and the prediction of End Stage Renal Disease (ESRD) based on the Mayo Clinic formula were calculated. Patients eligible for tolvaptan treatment (MCIC 1C, 1D, 1E, age<55 years old and e-GFR≥25 ml/min) were identified. We examined for possible associations using multinomial logistic regression and linear regression models.
Results
A total of 250 patients were included. Based on measurements of height-adjusted TKV (ht-TKV) and age, 8% of the patients were classified as 1A, 20% as 1B, 34% as 1C, 25% as 1D and 13% as 1E, MCIC. In multivariable analysis, patient’s age, male sex, parent’s age at ESRD (adjusted for patient age) and hypertension were associated with log (ht-TKV). Parent’s age at ESRD differed significantly between the MCICs of the offspring. The younger the parent diagnosed with ESRD, the more likely the patient will be diagnosed in the 1E stage. Similarly, there were significant differences in the presence and age of hypertension onset. In 157 patients (74 females and 83 males) who were eligible for tolvaptan treatment, the age at ADPKD diagnosis, at hypertension onset, and the parent’s age at ESRD were significantly lower when compared to non-eligible patients. Finally, factors associated with the prediction score of ESRD were hypertension, uric acid, and the age at ESRD of the affected parent.
Conclusion
As a heritability estimator, the age at ESRD of the affected parent was significantly associated with a worse phenotype, prognosis, and tolvaptan indication. Hypertension was associated with poor prognosis and an aggravated phenotype, whereas age at diagnosis of the disease and hypertension onset were associated with tolvaptan indication in ADPKD.