The relationship between e-GFR-based CKD evaluation of serum uromodulin level and MR imaging findings in autozomal dominant polycistic kidney patients, prognostic assessment

Introduction and objective: Autosomal Dominant Polycystic Kidney Disease is a hereditary disease which is characterized by the development of multiple cysts and kidney size in both kidneys, progressing to end-stage renal disease and causing renal damage. The identification of individuals with a high risk of progression to chronic kidney disease may be important in determining the target patients who will benefit from specific therapies or prognosis. In this study, we aimed to evaluate the prognostic evaluation of serum uromodulin level in patients with autosomal dominant polycystic kidney disease, total renal volume measured in magnetic resonance imaging and relationship with chronic kidney disease staging based on glomerular filtration rate. Material and Methods: A single-center, cross-sectional study was conducted in 2018 in a total of 18 healthy volunteers and 54 adult patients diagnosed with autosomal dominant polycystic kidney disease with imaging method and family history in the Nephrology Outpatient Clinic of Akdeniz University Hospital. Uromodulin levels were compared in both groups and total renal volume measurements and uromodulin levels were compared between patient subgroups and their relationship with glomerular filtration rate was evaluated. Results: Serum uromodulin levels were significantly higher in the control group than in the Autosomal Dominant Polycystic Kidney Disease group (p=0.021). However, there was a decrease in uromodulin levels in the subgroups formed according to the glomerular filtration rate of the patients, but statistical significance was not observed. There was a significant difference in total renal volume between the patient subgroups (p = 0.018). Although there was a positive correlation between glomerular filtration rate and uromodulin (p=0.02) and negative correlation between glomerular filtration rate and total kidney volume (p=0.001), no correlation was found between Uromodulin and total kidney volume. In the regression analysis, 7.5% of the change in serum uromodulin value can be explained by the change in glomerular filtration rate. Conclusion: The level of serum uromodulin correlates with the glomerular filtration rate and has a causal relationship. There was no correlation between serum uromodulin level and total renal volume. Serum uromodulin level may be useful in monitoring renal function in individuals with autosomal dominant polycystic kidney disease. Key words: Autosomal Dominant Polycystic Kidney Disease, Uromodulin, Total kidney volume