Renal and cardiac evaluation in polycystic kidney patients

ABSTRACT Renal and Cardiac Evaluation in Polycystic Kidney Patients Aim: Autosomal Dominant Kidney disease(ADPKD) is the most common inherited kidney disease. In this study, we aimed to investigate the relationship between kidney volume, proteinuria kidney function tests and echocardiographic findings in patients with ADPKD; and to evaluate the emotional state and general health parameters of these patients. Material and method: Fifty-two patients with ADPKD were included in the study. Anamnesis, physical examinations, kidney/liver function tests, lipids, complete blood count results were recorded. Kidney volumes were measured by ultrasonography/magnetic resonance imaging. With echocardiography; Global Longitudinal Strain, Left Ventricular Mass index, and Relative Wall Thickness were calculated. Beck's depression inventory and SF36 health status questionnaire were evaluated. Results: The mean age of 52 patients included in the study, 23 of whom were male, was 47.3±13.9 years. Blood pressure averages; systolic was 126.7±9.2mmHg, diastolic was 80.1±6.9mmHg. 17.3% of the patients were using angiotensin converting enzyme inhibitor(ACEI) and 40.4% were using angiotensin receptor blocker(ARB). 65.3% of those with liver cysts were women. The mean total kidney volume(TKV) of the patients was 1861.1±1193.2ml, and the height-adjusted total kidney volume(HATKV) was 11.7±7.5ml/m. The mean global longitudinal strain(GLS) of the patients was -18.7±3.1 and the left ventricular mass index(LVMI) was 92.9±27.5g/m2. Patients who received renal replacement therapy had significantly higher LVMI than those who did not. LVMI was significantly lower in those who used RAAS blockers than in those who did not. Total cholesterol and LDL were significantly lower in those with GLS <-17.8. GLS and renal volume, loss of GFR, proteinuria were unrelated. TKV/HATKV was moderately positively associated with proteinuria. SF36 health status parameters correlated with HATKV. Discussion: Patients using RAAS blockers compared to non-users; left ventricular hypertrophy was found less severe with echocardiographic evaluation. A moderate correlation was found between TKV and HATKV and proteinuria. Although there was no significant relationship between GLS and HATKV, loss of GFR and proteinuria, interestingly, a significant relationship was found between total cholesterol and LDL levels and GLS. The increase in kidney size was correlated with the negative parameters in the SF36 general health evaluation. It would be appropriate to evaluate the relationship between echocardiographic parameters such as proteinuria, kidney volume and GLS within larger ADPKD patient groups. Keywords: ADPKD, GLS, LVMI, RWT, TKVi HATKV, MRI, proteinuria