Factors affecting survival in adult TYPE autosomal dominant polycystic kidney disease

INTRODUCTION and AIM Adult Type Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common hereditary renal disease. End-stage renal failure (ESRD) is more rapid in some patients. Recognition of high-risk patients at the time of diagnosis is of paramount importance for treatment management. In this study, we aimed to investigate two new parameters (mean proteinuria and mean blood pressure) which may be valuable in predicting the progression of renal failure besides the demographic and clinical features of 196 patients with adult-type ADPKD which are followed up by Dokuz Eylul University Medical Faculty Hospital (DEUTF) Nephrology clinic. METHOD: Demographic, clinical, laboratory and imaging data of 116 patients included in the study were retrospectively analyzed. Demographic, clinical, laboratory and imaging features of the patients were examined from the outpatient clinic files. GFR, annual GFR changes measured at the first and last visit, and renal axis lengths measured by USG were evaluated. The mean blood pressure and proteinuria values were measured at each visit and their relationship with the development of ESRD was examined. FINDINGS: The most common clinical finding was hypertension. 71% of patients were receiving RAS (renin angiotensin aldosterone system) blockade treatment. Liver cysts were the most common extrarenal organ involvement. Significant correlation was found between mean systolic blood pressure and ultrasonography (USG) and right and left renal axis length (p = 0,004) and final GFR (p = 0002). In addition, there was a significant correlation between mean proteinuria and renal replacement therapy (RRT) and the final glomerular filtration rate (GFR). RESULT: Mean proteinuria and mean blood pressure level correlated with the renal axis measured by USG used in predicting progression and the time until the need for RRT, therefore these parameters are promising for high-risk patients.