title: Kidney volume and functional outcomes in autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency.
  
  
  METHODS
  This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal function. Magnetic resonance imaging and iothalamate clearance were used to measure htTKV and GFR, respectively. The association between baseline htTKV and the attainment of stage 3 CKD (GFR <60 ml/min per 1.73 m(2)) during follow-up was determined.
  
  
  RESULTS
  After a mean follow-up of 7.9 years, stage 3 CKD was attained in 30.7% of the enrollees. Using baseline htTKV, negative correlations with GFR increased from -0.22 at baseline to -0.65 at year 8. In multivariable analysis, a baseline htTKV increase of 100 cc/m significantly predicted the development of CKD within 8 years with an odds ratio of 1.48 (95% confidence interval: 1.29, 1.70). In receiver operator characteristic curve analysis, baseline htTKV of 600 cc/m most accurately defined the risk of developing stage 3 CKD within 8 years with an area under the curve of 0.84 (95% confidence interval: 0.79, 0.90). htTKV was a better predictor than baseline age, serum creatinine, BUN, urinary albumin, or monocyte chemotactic protein-1 excretion (P<0.05).
  
  
  CONCLUSIONS
  Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.
authors.affiliation: Emory University School of Medicine, Atlanta, GA 30322, USA. Arlene_chapman@emory.org
authors.forename: Arlene B
authors.initials: AB
authors.lastname: Chapman
authors.forename: James E
authors.initials: JE
authors.lastname: Bost
authors.forename: Vicente E
authors.initials: VE
authors.lastname: Torres
authors.forename: Lisa
authors.initials: L
authors.lastname: Guay-Woodford
authors.forename: Kyongtae Ty
authors.initials: KT
authors.lastname: Bae
authors.forename: Douglas
authors.initials: D
authors.lastname: Landsittel
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Bernard F
authors.initials: BF
authors.lastname: King
authors.forename: Diego
authors.initials: D
authors.lastname: Martin
authors.forename: Louis H
authors.initials: LH
authors.lastname: Wetzel
authors.forename: Mark E
authors.initials: ME
authors.lastname: Lockhart
authors.forename: Peter C
authors.initials: PC
authors.lastname: Harris
authors.forename: Marva
authors.initials: M
authors.lastname: Moxey-Mims
authors.forename: Mike
authors.initials: M
authors.lastname: Flessner
authors.forename: William M
authors.initials: WM
authors.lastname: Bennett
authors.forename: Jared J
authors.initials: JJ
authors.lastname: Grantham
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007483:Iothalamic Acid; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States; D055815:Young Adult
chemical_list: D007483:Iothalamic Acid