2009, Number 5
<< Back Next >>
Rev Invest Clin 2009; 61 (5)
Clinical and laboratorial predictors related to progression to chronic kidney disease in patients with autosomal dominant polycystic kidney disease
Dehesa-López E, Pérez-Gutiérrez RA, Valdez-Ortiz R, Morales-Buenrostro LE, Correa-Rotter R
Language: Spanish
References: 20
Page: 364-370
PDF size: 74.46 Kb.
ABSTRACT
Objective. To determine clinical and laboratorial factors related
to progression to chronic kidney disease in patients with
autosomal dominant polycystic kidney disease (ADPKD).
Material
and methods. Retrolective cohort. We reviewed the
files of patients with diagnosis of ADPKD between 1980 and
2008. We collected demographic, clinical and laboratory data.
The primary endpoint was the development of advanced kidney
disease (GFR estimated ‹ 15 mL/min with MDRD, renal
replacement therapy or kidney transplantation). The Cox proportional
hazards model was used to investigate the effect of
clinical and laboratorial covariates on the progression to advanced
kidney disease.
Results. Advanced chronic kidney disease
developed in 37.4% (n = 34) of the patients with median
survival renal of 57 years (IC95% 50.3-63.8). Variables associated
with progression to advanced chronic kidney disease in
the multivariate analysis were the levels of serum creatinine
(HR = 1.59 IC95% 0.99-2.55 p = 0.05) and dyslipidemia (HR
= 3.40; IC95% 1.23-9.39; p = 0.01).
Conclusions. Progression
to advanced chronic renal failure was common in our
population and the predicting factors for progression were the
levels of serum creatinine and dyslipidemia.
REFERENCES
Wilson PD. Polycystic kidney disease. N Engl J Med 2004; 350: 151-64.
Chang MY, Ong AC. Autosomal dominant polycystic kidney disease: recent advances in pathogenesis and treatment. Nephron Physiol 2008; 108: 1-7.
Harris PC. Autosomal dominant polycystic kidney disease: clues to pathogenesis. Hum Mol Genet 1999; 8: 1861-6.
Higashihara E, Nutahara K, Kojima M, Tamakoshi A, Yoshiyuki O, Sakai H, et al. Prevalence and renal prognosis of diagnosed autosomal dominant polycystic kidney disease in Japan. Nephron 1998; 80: 421-7.
Dalgaard OZ. Bilateral polycystic disease of the kidneys: a follow- up of two hundred and eighty-four patients and their families. Acta Med Scand 1957; 328(Suppl.): 1-255.
Iglesias CG, Torres VE, Offord KP, Holley KE, Beard CM, Kurland LT. Epidemiology of adult polycystic kidney disease, Olmsted County, Minnesota: 1935-1980. Am J Kidney Dis 1983; 2: 630-9.
Deirde AO, Vicente ET. Autosomal Dominant Polycystic Kidney Disease. En: Comprehensive clinical nephrology. 3rd Philadelphia, USA: Ed. Mosby; 2007, p. 597-609.
Vicente ET, Jared JG. Cystic Diseases of the Kidney. En: Brenner and Rector’s The Kidney. 8th Ed. Philadelphia: Saunders Elsevier; 2007, p. 1429-43.
Gabow PA, Jonhson AM, Kaenhy WD, Kimberling WJ, Lezotte DC, Duley IT, Jones RH. Factors affecting the progression of renal disease in autosomal dominant polycystic kidney disease. Kidney Int 1992; 41: 1311-19.
Schrier RW, McFann KK, Johnson AM. Epidemiological study of kidney survival in autosomal dominant polycystic kidney disease. Kidney Int 2003; 63: 678-85.
Linda FF. Effects of HMG-CoA reductase inhibitors (statins) on progression on kidney disease. Kidney Int 2008; 74: 571-6.
Samuelsson O, Mulec H, Knight-Gibson C, Attman PO, Kron B, Larsson R, et al. Lipoprotein abnormalities are associated with increased rate of progression of human chronic renal insufficiency. Nephrol Dial Transplant 1997; 12: 1908-15.
Ravid M, Brosh D, Ravid-Safran D, Levy Z, Rachmani R. Main risk factors for nephropathy in type 2 diabetes mellitus are plasma cholesterol levels, mean blood pressure, and hyperglycemia. Arch Intern Med 1998; 158: 998-1004.
Krolewski AS, Warram JH, Christlieb AR. Hypercholesterolemia– a determinant of renal function loss and deaths in IDDM patients with nephropathy. Kidney Int Suppl 1994; 45: S125-S131.
Appel GB, Radhakrishnan J, Avram MM, DeFronzo RA, Escobar- Jimenez F, Campos MM, et al. Analysis of metabolic parameters as predictors of risk in the RENAAL study. Diabetes Care 2003; 26: 1402-07.
Ecder T, Schrier RW. Hypertension in autosomal-dominant polycystic kidney disease: early occurrence and unique aspects. J Am Soc Nephrol 2001; 12: 194-200.
Johnson AM, Gabow PA. Identification of patients with autosomal dominant polycystic kidney disease at highest risk for end-stage renal disease. J Am Soc Nephrol 1997; 8: 1560-7.
Gretz N, Zeier M, Geberth S, Strauch M, Ritz E. Is gender a determinant for evolution of renal failure? A study in autosomal dominant polycystic kidney disease. Am J Kidney Dis 1989; 14: 178-83.
Choukroun G, Itakura Y, Albouze G, Christophe JL, Man NK, Grünfeld JP, et al. Factors influencing progression of renal failure in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1995; 6: 1634-42.
Chapman AB, Johnson A, Gabow PA, Schrier RW. The reninangiotensin- aldosterone system and autosomal dominant polycystic kidney disease. N Engl J Med 1990; 323: 1091-6.