Kidney Week

Abstract: FR-PO0082

Early Cardiac Remodeling Predicts Kidney Outcomes in Patients with ADPKD

Session Information

• ADPKD and Cystic Kidney Disease - 2
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic (Monogenic)

Authors

• Takahashi, Rina, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Rina Takahashi, MD, PhD

• Kataoka, Hiroshi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Hiroshi Kataoka, MEd

• Ushio, Yusuke, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Yusuke Ushio, MD, PhD

• Makabe, Shiho, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Shiho Makabe, MD

• Manabe, Shun, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Shun Manabe, MD, PhD

• Ito, Jun, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Jun Ito, MD, PhD

• Tsuchiya, Ken, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Ken Tsuchiya, MD, PhD

• Nitta, Kosaku, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Kosaku Nitta, MD, MEd, PhD

• Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan

Junichi Hoshino, MD, PhD, MPH

Background

Cardiovascular abnormalities are common in autosomal dominant polycystic kidney disease (ADPKD), but the prognostic significance of early structural cardiac remodeling remains unclear. We hypothesized that cardiac remodeling is associated with kidney disease progression in ADPKD.

Methods

We conducted a retrospective cohort study using an institutional PKD registry including 326 ADPKD patients. The primary exposure was left ventricular mass index (LVMI), and the primary outcome was a composite of 30% decline in estimated glomerular filtration rate (eGFR) or initiation of renal replacement therapy (RRT). Associations between LVMI and renal outcomes were evaluated using Kaplan–Meier and Cox proportional hazards analyses adjusted for age, sex, kidney function, body mass index, systolic blood pressure, and antihypertensive medication use. Fine–Gray models accounting for death as a competing event were performed for RRT. We also examined associations of valvular burden (total number of mild-or-greater MR, AR, TR, and PR) with LVMI and LVEF.

Results

Among 290 patients included in the time-to-event analysis, 148 composite renal events occurred during a median follow-up of 333.5 days. Higher LVMI was associated with worse renal outcomes in a graded manner (log-rank p < 0.0001). In multivariable Cox models, LVMI remained independently associated with the composite renal outcome (hazard ratio [HR], 1.10 per 10 g/m² increase; 95% confidence interval [CI], 1.03–1.17). This association was consistent in competing risk analyses for RRT (subdistribution HR, 1.10; 95% CI, 1.02–1.18). Valvular burden was positively associated with LVMI (adjusted β, +5.02 g/m² per valve; 95% CI, 2.86–7.19), whereas no significant association was observed with LVEF.

Conclusion

Increased LVMI was independently associated with renal disease progression in ADPKD. Valvular burden was associated with higher LVMI despite preserved systolic function, supporting the role of early structural cardiac remodeling as a predictor of kidney outcomes.

Funding

• Clinical Revenue Support