title: Glomerular hyperfiltration and renal progression in children with autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  The purpose of this study was to determine whether glomerular hyperfiltration (GH) occurring early in autosomal dominant polycystic kidney disease (ADPKD) is indicative of more rapid disease progression in children.
  
  
  METHODS
  One hundred eighty children with ADPKD (ages 4 to 18 years) with normal renal function were examined by renal ultrasound. Renal volume was calculated using a standard formula for a modified ellipsoid. Creatinine clearance was calculated from serum creatinine and 24-hour urine creatinine. GH was defined as creatinine clearance ≥140 ml/min per 1.73 m(2).
  
  
  RESULTS
  Thirty-two children had GH (mean age 11.4 ± 3.6 years) and 148 had normal renal function (mean age 10.8 ± 3.9 years). Patients with GH at baseline demonstrated an increased rate of total renal volume growth (β: rate of change = +19.3 ± 10.8 cm(3)/year) over 5 years compared with those without GH at baseline (β = -4.3 ± 7.7 cm(3)/year), P = 0.008. Those with GH at baseline experienced a faster decline in creatinine clearance in subsequent years (β = -5.0 ± 0.8 ml/min per 1.73 m(2) per year) compared with those without GH at baseline (β = +1.0 ± 0.4 ml/min per 1.73 m(2) per year), P < 0.0001.
  
  
  CONCLUSIONS
  This study revealed that occurrence of GH in ADPKD children is associated with a significantly faster decline in renal function and higher rate of kidney enlargement over time. GH combined with the increased renal volume may therefore be used as an early marker for a more severe progression of ADPKD in children.
authors: University of Colorado Denver, Division of Renal Diseases and Hypertension, Aurora, CO 80045, USA.
authors: Imed
authors: I
authors: Helal
authors: Berenice
authors: B
authors: Reed
authors: Kim
authors: K
authors: McFann
authors: Xiang-Dong
authors: XD
authors: Yan
authors: Godela M
authors: GM
authors: Fick-Brosnahan
authors: Melissa
authors: M
authors: Cadnapaphornchai
authors: Robert W
authors: RW
authors: Schrier
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D003404:Creatinine / Q000097:blood / Q000652:urine; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000000981:diagnostic imaging / Q000235:genetics / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D003404:Creatinine