title: Chronic kidney disease progression in patients with autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  The aim of this study was to analyse the factors influencing chronic kidney disease (CKD) progression in patients with autosomal dominant polycystic kidney disease (ADPKD).
  
  
  METHODS
  We studied 101 patients (mean age: 43 +/- 17.3 years, 43.56% male) followed during a median (interquartile range) follow-up time of 69 (35-128) months from 1997 to 2010. The primary end point was: time to a 50% decrease of estimated glomerular filtration rate (eGFR) (CKD-EPI) since the first-time visit and/or time to initiation of renal replacement therapy, and the annual mean change of eGFR was also analysed. Clinical and demographic data, blood pressure, concomitant medications, and analytical parameters were collected at each visit. Baseline kidney size was also recorded by ultrasound.
  
  
  RESULTS
  Thirty-one patients achieved the primary end point after a median (IQR) time of 102 (53-131) months. Those patients who achieved the primary end point had higher SBP and DBP (P=0.017 and P=0.001), higher LDL-cholesterol (P=0.011), higher creatinine (P=0.006), higher uricemia (P=0.041), more severe proteinuria (P=0.033) and greater kidney size (P=0.05). The mean annual eGFR change was of -3.52 +/- 7.3ml/min/1.73m2. Forty-nine patients had a rapid decline in renal function: Group A (higher than -3.52ml/min/1.73m2) and 52 patients had a lower renal disease progression: Group B (<-3.2 ml/min/1.73 m2). Adjusted Cox regression analysis showed that higher SBP and younger age at the first visit were independent variables for poorer renal outcome (P=0.026).
  
  
  CONCLUSIONS
  Initial kidney function, proteinuria, renal size, hypercholesterolemia, hyperuricemia, and SBP are the factors that influence CKD progression in ADPKD. SBP and younger age at diagnosis are the only factors that maintain their independent predictive value in a multivariant analysis.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Nayara
authors.initials: N
authors.lastname: Panizo
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: Soledad
authors.initials: S
authors.lastname: García de Vinuesa
authors.forename: David
authors.initials: D
authors.lastname: Arroyo
authors.forename: Claudia
authors.initials: C
authors.lastname: Yuste
authors.forename: Abraham
authors.initials: A
authors.lastname: Rincón
authors.forename: Ursula
authors.initials: U
authors.lastname: Verdalles
authors.forename: Caridad
authors.initials: C
authors.lastname: Ruiz-Caro
authors.forename: Borja
authors.initials: B
authors.lastname: Quiroga
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies