Abstract: SA-PO0554
Association of Total Kidney Volume and Diabetes with CKD Progression and Mortality Outcomes in ADPKD
Session Information
- Cystic Kidney Diseases: Clinical Research
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1201 Genetic Diseases of the Kidneys: Monogenic Kidney Diseases
Authors
- Robinson-Cohen, Cassianne, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Battram, Thomas, Bayer AG, Leverkusen, NRW, Germany
- Below, Jennifer E., Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Kota, Savithri B., Bayer AG, Leverkusen, NRW, Germany
- Hung, Adriana, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Petty, Alexander S, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background
Autosomal dominant polycystic kidney disease (ADPKD) is a heritable disorder marked by cystic kidney enlargement, progressive kidney function decline, and high risk of end-stage kidney disease (ESKD). Diabetes is a common comorbidity that may influence disease progression, though its role remains uncertain.
Methods
We conducted a cohort study of adults with ADPKD treated at Vanderbilt University Medical Center (1996–2024), defining baseline as the first available TKV measurement (MRI or ultrasound). Outcomes included incident CKD progression (50% eGFR decline or kidney failure) and death. Cox models assessed associations between TKV and outcomes, overall and by diabetes status.
Results
Among 1,317 participants (mean age 57±15 years, 43% female), 35% had diabetes. Median baseline TKV was 518 mL (IQR 489–596). Over a median 3.2 years, 305 developed CKD progression and 354 died. Each doubling in TKV was associated with higher mortality (HR 1.28 [1.05–1.56]) but not with CKD progression (HR 0.95 [0.55–1.64]). In non-diabetic patients, higher TKV was associated with both death (HR 1.43 [0.94–2.18]) and CKD progression (HR 1.67 [1.08–2.58]). No significant associations were seen among those with diabetes.
Conclusion
Larger TKV was linked to increased mortality in ADPKD, especially among non-diabetics. Diabetes may alter the typical structural-functional trajectory in ADPKD, underscoring the need to account for comorbidity profiles when evaluating TKV as a prognostic marker.
Funding
- Commercial Support – Bayer