Magnetic resonance imaging of kidney and cyst volume in children with ADPKD.
OBJECTIVE
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and has important clinical manifestations in childhood. Numerous studies have documented the superiority of magnetic resonance imaging (MRI) for serial monitoring of kidney and cyst volume in this condition in adults. However, no studies have examined the utility of MRI for serial assessment of kidney and cyst volume in children with ADPKD.


METHODS
Subjects 4 to 21 years of age with ADPKD underwent abdominal MRI on an annual basis for 5 years. Subjects were grouped according to BP as hypertensive (HBP; BP≥95th percentile for age, height, and gender) or as normotensive (NBP; BP<95th percentile). Total kidney volume (TKV), cyst volume, and cyst number were assessed by stereology.


RESULTS
MRI studies (n=302) were obtained in 77 children with ADPKD. TKV and cyst volume were significantly increased in HBP versus NBP subjects. HBP subjects demonstrated a greater increase in fractional cyst volume over time versus NBP subjects. Cyst number increased more rapidly in HBP ADPKD children.


CONCLUSIONS
This is the first large-scale clinical study examining the utility of MRI for serial assessment of TKV, cyst volume, and cyst number in children with ADPKD. These results demonstrate that MRI is an acceptable means to follow these parameters in children with ADPKD. Because of the embryonic occurrence of cysts, interventional trials are needed in ADPKD children and MRI may be the preferred renal imaging approach.
Department of Pediatrics, PKD Research Group, University of Colorado Denver, and Department of Radiology, The Children's Hospital, 13001 East 17th Place, Box C283, Aurora, CO 80045, USA. Melissa.Cadnapaphornchai@ucdenver.edu
Melissa A
MA
Cadnapaphornchai
Amirali
A
Masoumi
John D
JD
Strain
Kim
K
McFann
Robert W
RW
Schrier
D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007668:Kidney / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D055815:Young Adult