Analysis of baseline parameters in the HALT polycystic kidney disease trials.
HALT PKD consists of two ongoing randomized trials with the largest cohort of systematically studied patients with autosomal dominant polycystic kidney disease to date. Study A will compare combined treatment with an angiotensin-converting inhibitor and receptor blocker to inhibitor alone and standard compared with low blood pressure targets in 558 early-stage disease patients with an eGFR over 60 ml/min per 1.73 m(2). Study B will compare inhibitor-blocker treatment to the inhibitor alone in 486 late-stage patients with eGFR 25-60 ml/min per 1.73 m(2). We used correlation and multiple regression cross-sectional analyses to determine associations of baseline parameters with total kidney, liver, or liver cyst volumes measured by MRI in Study A and eGFR in both studies. Lower eGFR and higher natural log-transformed urine albumin excretion were independently associated with a larger natural log-transformed total kidney volume adjusted for height (ln(HtTKV)). Higher body surface area was independently associated with a higher ln(HtTKV) and lower eGFR. Men had larger height-adjusted total kidney volume and smaller liver cyst volumes than women. A weak correlation was found between the ln(HtTKV) and natural log-transformed total liver volume adjusted for height or natural log liver cyst volume in women only. Women had higher urine aldosterone excretion and lower plasma potassium. Thus, our analysis (1) confirms a strong association between renal volume and functional parameters, (2) shows that gender and other factors differentially affect the development of polycystic disease in the kidney and liver, and (3) suggests an association between anthropomorphic measures reflecting prenatal and/or postnatal growth and disease severity.
Mayo Clinic College of Medicine, Rochester, Minnesota 55901, USA. torres.vicente@mayo.edu
Vicente E
VE
Torres
Arlene B
AB
Chapman
Ronald D
RD
Perrone
K Ty
KT
Bae
Kaleab Z
KZ
Abebe
James E
JE
Bost
Dana C
DC
Miskulin
Theodore I
TI
Steinman
William E
WE
Braun
Franz T
FT
Winklhofer
Marie C
MC
Hogan
Frederic R
FR
Oskoui
Cass
C
Kelleher
Amirali
A
Masoumi
James
J
Glockner
Neil J
NJ
Halin
Diego R
DR
Martin
Erick
E
Remer
Nayana
N
Patel
Ivan
I
Pedrosa
Louis H
LH
Wetzel
Paul A
PA
Thompson
J Philip
JP
Miller
Catherine M
CM
Meyers
Robert W
RW
Schrier
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D003560:Cysts / Q000235:genetics / Q000473:pathology; D018450:Disease Progression; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D020022:Genetic Predisposition to Disease; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D008107:Liver Diseases / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents