title: Cutaneous microcirculation is impaired in early autosomal dominant polycystic kidney disease.
abstract: 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.
authors: Division of Nephrology, Department of Internal and Public Medicine, University of Bari, Bari, Italy. a.ramunni@nephro.uniba.it
authors: Alfonso
authors: A
authors: Ramunni
authors: Paola
authors: P
authors: Brescia
authors: Domenico
authors: D
authors: Quaranta
authors: Maria Stella
authors: MS
authors: Bianco
authors: Prudenza
authors: P
authors: Ranieri
authors: Ernesta
authors: E
authors: Dolce
authors: Pasquale
authors: P
authors: Coratelli
mesh_terms: 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