Kim Hyunsuk, Koh Junga, Park Sue K, Oh Kook H, Kim Yeong H, Kim Yaeni, Ahn Curie, Oh Yun K
Department of Internal Medicine, Hallym University Medical Center, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Nephrology (Carlton). 2019 Apr;24(4):422-429. doi: 10.1111/nep.13407.
The aim of this study was to describe the baseline characteristics of autosomal-dominant polycystic kidney disease (ADPKD) in a cohort of Korean patients with chronic kidney disease (CKD).
From April 2011 to February 2016, patients with CKD stage 1-5 (pre-dialysis) were enrolled as an ADPKD sub-cohort of the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease. Baseline characteristics, the correlation of kidney and liver volume and kidney function and the factors associated with kidney function were analysed.
A total of 364 ADPKD patients with a mean estimated glomerular filtration rate (eGFR) of 68.1 ± 33.3 mL/min per 1.73 m (50.5% male with a mean age of 47.0 ± 10.6 years) were enrolled from nine hospitals in Korea. Initially, 55.8% of the patients were asymptomatic, and pain was the most common symptom (12.9%); 87.6 and 77.5% of the patients had hypertension and hepatic cysts, respectively. The height-adjusted total kidney volumes (htTKV) were higher in male patients than in female patients. In contrast, the height-adjusted total liver volumes were higher in female patients than in male patients. The decrease rate of eGFR depending on Log(htTKV) was larger in the group aged between 41 and 50 years than the other age groups. Older age, a higher 24-h urine protein excretion, larger htTKV and hyperuricemia were independently associated with lower eGFR, whereas using febuxostat was independently associated with higher eGFR.
This sub-cohort will provide clinical characteristics and outcomes of Korean ADPKD patients, which can be compared with those of other previous cohorts. We have identified factors associated with advanced-stage CKD in Korean patients with ADPKD.
本研究旨在描述一组韩国慢性肾脏病（CKD）患者中常染色体显性遗传性多囊肾病（ADPKD）的基线特征。
2011年4月至2016年2月，CKD 1-5期（透析前）患者被纳入韩国慢性肾脏病患者结局队列研究的ADPKD亚组。分析了基线特征、肾脏和肝脏体积与肾功能的相关性以及与肾功能相关的因素。
从韩国9家医院共纳入364例ADPKD患者，平均估计肾小球滤过率（eGFR）为68.1±33.3 mL/（min·1.73 m²）（50.5%为男性，平均年龄47.0±10.6岁）。最初，55.8%的患者无症状，疼痛是最常见的症状（12.9%）；分别有87.6%和77.5%的患者患有高血压和肝囊肿。男性患者的身高校正后总肾体积（htTKV）高于女性患者。相反，女性患者的身高校正后总肝体积高于男性患者。41至50岁年龄组的eGFR随Log(htTKV)的下降率大于其他年龄组。年龄较大、24小时尿蛋白排泄量较高、htTKV较大和高尿酸血症与较低的eGFR独立相关，而使用非布司他与较高的eGFR独立相关。
该亚组将提供韩国ADPKD患者的临床特征和结局，可与既往其他队列进行比较。我们已经确定了韩国ADPKD患者中与晚期CKD相关的因素。
