Cutaneous microcirculation is impaired in early autosomal dominant polycystic kidney disease.
OBJECTIVE
An endothelial dysfunction has been described in autosomal dominant polycystic kidney disease (ADPKD) before the development of hypertension and renal impairment. The aim of this work was to verify the existence of a microvascular reactivity in the early stages of ADPKD.


METHODS
Fifteen ADPKD normotensive patients with normal renal function underwent laser Doppler examination of the cutaneous microcirculation in basal conditions and after the warm test, as well as evaluation of plasma concentrations of some endothelial activation parameters [total cholesterol and fractions, fibrinogen, von Willebrand factor, Lp(a)]. The results were compared with those in 15 healthy subjects, 15 essential hypertensive patients and 15 hypertensive ADPKD patients with normal renal function.


RESULTS
Both basal and post-warm-test values were significantly lower in normotensive ADPKD subjects than controls (3.2 +/- 1 vs. 5.8 +/- 1.3 AU, p = 0.0001; 35.2 +/- 10.9 vs. 50.5 +/- 10.8 AU, p = 0.005, respectively). All evaluated parameters were within normal limits and comparable between normotensive ADPKD subjects and controls, except for LDL cholesterol (125 +/- 18 vs. 101 +/- 22 mg/dl, p = 0.01) and Lp(a), which was significantly higher in the ADPKD subjects (52.2 +/- 36 vs. 6.0 +/-4 mg/dl, p = 0.0006).


CONCLUSIONS
Our study confirms the existence of a systemic microcirculation defect in ADPKD. The presence of high levels of Lp(a) could contribute to causing the high incidence of cardiovascular events in ADPKD.
Ramunni
Alfonso
A
Division of Nephrology, Department of Internal and Public Medicine, University of Bari, Bari, Italy. a.ramunni@nephro.uniba.it
Brescia
Paola
P
Quaranta
Domenico
D
Bianco
Maria Stella
MS
Ranieri
Prudenza
P
Dolce
Ernesta
E
Coratelli
Pasquale
P
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000000981:diagnostic imaging*; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000000981:diagnostic imaging*; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging*; D014463:Ultrasonography