Department of Urology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Clin Exp Nephrol. 2011 Aug;15(4):539-45. doi: 10.1007/s10157-011-0428-y. Epub 2011 Mar 24.
In patients with autosomal dominant polycystic kidney disease (ADPKD), renal cysts grow exponentially. Since remaining renal parenchyma has a capacity to compensate for the loss of glomerular filtration, the glomerular filtration rate (GFR) may be sustained until the disease progresses. The purpose of this study was to determine if renal volumetric indices and clinical parameters are associated with renal function in Japanese patients with ADPKD.
In 73 ADPKD patients (28 men, 45 women), the associations of mean systolic blood pressure, mean diastolic blood pressure, estimated GFR (eGFR), the amount of proteinuria and albuminuria, body mass index (BMI), brachial-ankle pulse wave velocity (baPWV), ankle-brachial index, and total kidney volume (TKV) were retrospectively analyzed.
Multivariate linear regression analysis showed that eGFR was significantly and independently inversely correlated with patients' age and BMI. The median change in eGFR per year (ΔeGFR/y) was -2.8 ml/min/1.73 m(2)/year. Multiple linear regression analysis showed that ΔeGFR/y was significantly and independently inversely correlated with the change in TKV per year (ΔTKV/y). Multiple linear regression analysis showed that ΔTKV/y was significantly related to initial TKV and the change in albuminuria per year.
This study demonstrated a significant relationship between the change in renal function and the change in renal volume in Japanese ADPKD patients without renal insufficiency. It is possible that the volume measurements can be used as useful markers for disease progression in Japanese ADPKD patients.
常染色体显性多囊肾病（ADPKD）患者的肾囊肿呈指数级生长。由于剩余的肾实质有能力代偿肾小球滤过率的损失，因此肾小球滤过率（GFR）可能在疾病进展之前保持不变。本研究旨在确定日本 ADPKD 患者的肾脏体积指数和临床参数是否与肾功能相关。
在 73 名 ADPKD 患者（28 名男性，45 名女性）中，回顾性分析了平均收缩压、平均舒张压、估算肾小球滤过率（eGFR）、蛋白尿和白蛋白尿量、体重指数（BMI）、肱踝脉搏波速度（baPWV）、踝臂指数和总肾体积（TKV）与肾功能的关系。
多元线性回归分析显示，eGFR 与患者年龄和 BMI 呈显著负相关。eGFR 每年的中位数变化（ΔeGFR/y）为-2.8ml/min/1.73m(2)/year。多元线性回归分析显示，ΔeGFR/y 与 TKV 每年的变化（ΔTKV/y）呈显著负相关。多元线性回归分析显示，ΔTKV/y 与初始 TKV 和每年白蛋白尿的变化显著相关。
本研究表明，肾功能的变化与日本 ADPKD 患者肾功能正常患者的肾体积变化之间存在显著关系。体积测量值可能可作为日本 ADPKD 患者疾病进展的有用标志物。
