title: Renal disease progression in autosomal dominant polycystic kidney disease.
abstract: BACKGROUND
  Autosomal dominant polycystic kidney disease is a lifelong progressive disorder. However, how age, blood pressure, and stage of chronic kidney disease (CKD) affect the rate of kidney function deterioration is not clearly understood.
  
  
  METHODS
  In this long-term observational case study up to 13.9 years (median observation period for slope was 3.3 years), serum creatinine was serially measured in 255 mostly adult patients. The glomerular filtration rate was estimated (eGFR) using a modified Modification of Diet in Renal Disease Study method. The total kidney volume (TKV) has been measured in 86 patients at one center since 2006.
  
  
  RESULTS
  As age increased, eGFR declined significantly (P < 0.0001), but the annual rate of decline of eGFR did not correlate with age or initially measured eGFR. In patients with CKD stage 1, eGFR declined at a rate which was not significantly different from other advanced CKD stages. Hypertensive patients had lower eGFR and larger TKV than normotensive patients at a young adult age. The slopes of regression lines of eGFR and TKV in relation to age were not different between high and normal blood pressure groups.
  
  
  CONCLUSIONS
  The declining rate of eGFR was relatively constant and did not correlate with age or eGFR after adolescence. eGFR was already low in young adult patients with hypertension. As age increased after adolescence, eGFR declined and TKV increased similarly between normal and high blood pressure groups. eGFR starts to decline in patients with normal eGFR, suggesting that the decline starts earlier than previously thought.
authors.affiliation: Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan. ehigashi@ks.kyorin-u.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horie
authors.forename: Satoru
authors.initials: S
authors.lastname: Muto
authors.forename: Toshio
authors.initials: T
authors.lastname: Mochizuki
authors.forename: Saori
authors.initials: S
authors.lastname: Nishio
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nutahara
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000503:physiopathology*; D012189:Retrospective Studies
chemical_list: D003404:Creatinine