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Background <p>Autosomal dominant polycystic kidney disease (ADPKD) leads to end-stage renal disease (ESRD) in approximately half of all patients with ADPKD by their sixth decade of life. Factors that cause kidney function decline in these patients are unclear.</p> Methods <p>This retrospective study included 124 adult patients with ADPKD who were followed up between January 2014 and December 2022. The primary outcome was kidney function decline, which was defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 25% compared with that at baseline. A Cox proportional hazard analysis was performed to identify risk factors for kidney function decline.</p> Results <p>The median eGFR observation period was 30.0&#xa0;months (12.0–48.0&#xa0;months). Forty-eight patients experienced kidney function decline. The univariate Cox proportional hazards analysis indicated that duration ≥ 15&#xa0;years between the diagnosis and referral to a nephrologist, baseline eGFR level &lt; 57&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>, baseline height-adjusted total kidney volume (htTKV) ≥ 800&#xa0;mL/m, cyst infection, and proteinuria were associated with the risk of kidney function decline. Multivariate Cox proportional hazards analysis indicated that independent risk factors for kidney function decline were baseline htTKV ≥ 800&#xa0;mL/m (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.28–5.97; <i>P</i> = 0.01), cyst infection (HR, 2.54; 95% CI, 1.02–6.34; <i>P</i> = 0.046), and proteinuria (HR, 2.23; 95% CI, 1.22–4.25; <i>P</i> = 0.01).</p> Conclusions <p>To prevent kidney function decline in patients with ADPKD, cyst growth, cyst infection, and proteinuria should be closely monitored.</p>

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Clinical characteristics of patients with autosomal dominant polycystic kidney disease and risk factors for kidney function decline: a single-center study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月23日

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  • Masato Minami,
  • Shiroh Tanoue,
  • Takumi Ejima,
  • Tsubasa Uruta,
  • Satomi Ichida,
  • Hidehito Nakamura,
  • Masayuki Otsuka,
  • Takahiro Arima,
  • Rei Obo,
  • Yawara Yamashita,
  • Haruhito Yoshimine,
  • Masaharu Abe,
  • Yozo Yoshimine,
  • Masahide Furusho,
  • Eiji Saeki,
  • Shuji Kanmura,
  • Akio Ido

摘要

Background

Autosomal dominant polycystic kidney disease (ADPKD) leads to end-stage renal disease (ESRD) in approximately half of all patients with ADPKD by their sixth decade of life. Factors that cause kidney function decline in these patients are unclear.

Methods

This retrospective study included 124 adult patients with ADPKD who were followed up between January 2014 and December 2022. The primary outcome was kidney function decline, which was defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 25% compared with that at baseline. A Cox proportional hazard analysis was performed to identify risk factors for kidney function decline.

Results

The median eGFR observation period was 30.0 months (12.0–48.0 months). Forty-eight patients experienced kidney function decline. The univariate Cox proportional hazards analysis indicated that duration ≥ 15 years between the diagnosis and referral to a nephrologist, baseline eGFR level < 57 mL/min/1.73 m2, baseline height-adjusted total kidney volume (htTKV) ≥ 800 mL/m, cyst infection, and proteinuria were associated with the risk of kidney function decline. Multivariate Cox proportional hazards analysis indicated that independent risk factors for kidney function decline were baseline htTKV ≥ 800 mL/m (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.28–5.97; P = 0.01), cyst infection (HR, 2.54; 95% CI, 1.02–6.34; P = 0.046), and proteinuria (HR, 2.23; 95% CI, 1.22–4.25; P = 0.01).

Conclusions

To prevent kidney function decline in patients with ADPKD, cyst growth, cyst infection, and proteinuria should be closely monitored.