title: A comparison of ultrasound and magnetic resonance imaging shows that kidney length predicts chronic kidney disease in autosomal dominant polycystic kidney disease.
abstract: Autosomal dominant polycystic kidney disease (ADPKD) is marked by gradual renal cyst and kidney enlargement and ultimately renal failure. Magnetic resonance-based, height-adjusted total kidney volume (htTKV) over 600 cc/m predicts the development of CKD stage 3 within 8 years in the Consortium for Radiologic Imaging in Polycystic Kidney Disease cohort. Here we compared simultaneous ultrasound and magnetic resonance imaging to determine whether ultrasound and kidney length (KL) predict future CKD stage 3 over longer periods of follow-up. A total of 241 ADPKD patients, 15-46 years, with creatinine clearance of 70 ml/min and above had iothalamate clearance, magnetic resonance, and ultrasound evaluations. Participants underwent an average of five repeat clearance measurements over a mean follow-up of 9.3 years. Ultrasound and magnetic resonance-based TKV and KL were compared using Bland-Altman plots and intraclass correlations. Each measure was tested to predict future CKD stage 3. Relatively strong intraclass correlations between ultrasound and magnetic resonance were found for both htTKV and KL (0.81 and 0.85, respectively). Ultrasound and magnetic resonance-based htTKV and KL predicted future CKD stage 3 similarly (AUC of 0.87, 0.88, 0.87, and 0.88, respectively). An ultrasound kidney length over 16.5 cm and htTKV over 650 ml/min had the best cut point for predicting the development of CKD stage 3. Thus, kidney length alone is sufficient to stratify the risk of progression to renal insufficiency early in ADPKD using either ultrasound or magnetic resonance imaging.
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: Harpreet
authors.initials: H
authors.lastname: Bhutani
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: Vikram
authors.initials: V
authors.lastname: Smith
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: Frederic
authors.initials: F
authors.lastname: Rahbari-Oskoui
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: Ankush
authors.initials: A
authors.lastname: Mittal
authors.affiliation: Kansas University, Lawrence, Kansas, USA.
authors.forename: Jared J
authors.initials: JJ
authors.lastname: Grantham
authors.affiliation: Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Vicente E
authors.initials: VE
authors.lastname: Torres
authors.affiliation: University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Michal
authors.initials: M
authors.lastname: Mrug
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Kyongtae T
authors.initials: KT
authors.lastname: Bae
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Wu
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Ge
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Doug
authors.initials: D
authors.lastname: Landslittel
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Patrice
authors.initials: P
authors.lastname: Gibbs
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: W Charles
authors.initials: WC
authors.lastname: O'Neill
authors.affiliation: Emory University, Atlanta, Georgia, USA.
authors.forename: Arlene B
authors.initials: AB
authors.lastname: Chapman
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D003287:Contrast Media; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007483:Iothalamic Acid; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007483:Iothalamic Acid; D003404:Creatinine
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