Kidney Week

Abstract: FR-PO0912

Peripheral Microvascular Endothelial Dysfunction in Adolescents with ADPKD: A Pilot Study

Session Information

• Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Hanna, Christian, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Christian Hanna, MD, MS, FASN

• Eirin, Alfonso, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Alfonso Eirin, MD

• Abdelfattah, Ahmed, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Ahmed Abdelfattah, MBChB

• Zhang, Nathan G., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Nathan G. Zhang

• Xu, Xiaohong, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Xiaohong Xu, MD

• Iyer, Vinaya, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Vinaya Iyer, MBBS

• Zhang, Youwen, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Youwen Zhang, PhD

• Harris, Peter C., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Peter C. Harris, PhD

• Lerman, Lilach O., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Lilach O. Lerman, MD, PhD, FASN

• Irazabal, Maria V., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Maria V. Irazabal, MD, PhD

Background

Microvascular endothelial dysfunction (ED) may represent an early, potentially reversible stage of vascular injury that precedes macrovascular abnormalities and contributes to kidney disease progression. Although macrovascular ED has been described in adolescents with ADPKD, microvascular endothelial function has not been evaluated. We hypothesized that adolescents with ADPKD exhibit peripheral microvascular endothelial dysfunction (PMED) and explored its relationship with kidney structural disease severity.

Methods

We performed a cross-sectional analysis of 11 adolescents (15-18 years) with ADPKD and preserved kidney function (eGFR >90 mL/min/1.73 m²). Kidney disease severity was classified using the Mayo Imaging Classification (MIC). Peripheral microvascular endothelial function was assessed using digital peripheral arterial tonometry (EndoPAT); PMED was defined as a reactive hyperemia index (RHI) ≤1.8.

Results

PMED was observed in 7 of 11 adolescents (64%, Table). RHI was lower in individuals with PMED (p=0.001). LDL cholesterol levels were higher in the PMED group (p=0.015). Kidney function was preserved, and urinary albumin excretion was low. Ten of 11 participants and all individuals with PMED were classified as MIC-CDE, whereas the single MIC-AB participant did not exhibit PMED. Circulating biomarkers did not differ between groups.

Conclusion

In this small cohort, PMED was frequent despite preserved kidney function and minimal albuminuria, suggesting early microvascular involvement. These findings support a link between microvascular dysfunction and kidney structural disease burden. Differences in LDL cholesterol should be considered when interpreting these findings. If confirmed, microvascular assessment may help identify early vascular involvement and refine risk stratification. Larger pediatric studies are needed to confirm these findings.

Funding

• NIDDK Support