Pietrzak-Nowacka Maria, Safranow Krzysztof, Palacz Janina, Gołembiewska Edyta, Marchelek-Myśliwiec Małgorzata, Ciechanowski Kazimierz
a Department of Nephrology , Transplantology and Internal Medicine and.
Ren Fail. 2015 Jun;37(5):798-803. doi: 10.3109/0886022X.2015.1033608. Epub 2015 Apr 14.
The aim of the study was to evaluate an association between kidney and cyst dimensions and anthropometric, clinical and biochemical parameters of autosomal dominant polycystic kidney disease (ADPKD) patients. Forty-nine adults, ADPKD-diagnosed patients aged 36 ± 11 years, and 50 healthy controls were included in the study. Oral glucose tolerance test (OGTT with 75 g of glucose) was performed and venous blood was collected to measure biochemical parameters and various ion concentrations. Ultrasound abdominal examinations were performed with special emphasis on kidney and cysts parameters. In the ADPKD group, mean kidney length correlated positively with age, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose and glucose and C-peptide concentrations after 120 min of glucose intake and negatively with Mg(2+) concentration and glomerular filtration rate (eGFR). Multivariate analyses adjusted for age and gender showed that higher mean kidney length and maximal cyst diameter were significant predictors of higher SBP (p = 0.034 and 0.046, respectively) and DBP (p = 0.024 and 0.034, respectively), higher maximal cyst diameter was a significant predictor of higher OGTT 2-h C-peptide concentration (p = 0.033), higher mean cyst diameter was a significant predictor of lower eGFR (p = 0.039) and higher mean kidney length was a significant predictor of lower serum magnesium concentration (p = 0.043). In the ADPKD patients with normal GFR, mean kidney length and mean cyst diameter measured by ultrasonography are associated negatively with GFR and positively with blood pressure. Higher mean kidney length and cyst diameter might be indicators of disorders of glucose and magnesium metabolism which precede renal failure in patients with ADPKD.
本研究的目的是评估常染色体显性多囊肾病（ADPKD）患者的肾脏及囊肿大小与人体测量学、临床和生化参数之间的关联。本研究纳入了49名确诊为ADPKD的成年患者，年龄为36±11岁，以及50名健康对照者。进行了口服葡萄糖耐量试验（75g葡萄糖的OGTT），并采集静脉血以测量生化参数和各种离子浓度。进行腹部超声检查，特别关注肾脏和囊肿参数。在ADPKD组中，平均肾脏长度与年龄、收缩压（SBP）、舒张压（DBP）、空腹血糖以及摄入葡萄糖120分钟后的血糖和C肽浓度呈正相关，与Mg(2+)浓度和肾小球滤过率（eGFR）呈负相关。针对年龄和性别进行校正的多变量分析显示，较高的平均肾脏长度和最大囊肿直径是较高SBP（分别为p = 0.034和0.046）和DBP（分别为p = 0.024和0.034）的显著预测因素，较大的最大囊肿直径是较高的OGTT 2小时C肽浓度（p = 0.033）的显著预测因素，较高的平均囊肿直径是较低的eGFR（p = 0.039）的显著预测因素，较高的平均肾脏长度是较低的血清镁浓度（p = 0.043）的显著预测因素。在GFR正常的ADPKD患者中，超声测量的平均肾脏长度和平均囊肿直径与GFR呈负相关，与血压呈正相关。较高的平均肾脏长度和囊肿直径可能是ADPKD患者肾衰竭之前葡萄糖和镁代谢紊乱的指标。
