梅奥影像分类是韩国常染色体显性多囊肾病患者快速进展的良好预测指标：KNOW-CKD研究结果
Mayo imaging classification is a good predictor of rapid progress among Korean patients with autosomal dominant polycystic kidney disease: results from the KNOW-CKD study.
作者信息
Park Hayne Cho, Hong Yeji, Yeon Jeong-Heum, Ryu Hyunjin, Kim Yong-Chul, Lee Joongyub, Kim Yeong Hoon, Chae Dong-Wan, Chung WooKyung, Ahn Curie, Oh Kook-Hwan, Oh Yun Kyu
机构信息
Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea.
出版信息
Kidney Res Clin Pract. 2022 Jul;41(4):432-441. doi: 10.23876/j.krcp.21.261. Epub 2022 Mar 3.
BACKGROUND
Mayo imaging classification (MIC) is a useful biomarker to predict disease progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to validate MIC in the prediction of renal outcome in a prospective Korean ADPKD cohort and evaluate clinical parameters associated with rapid disease progression.
METHODS
A total of 178 ADPKD patients were enrolled and prospectively observed for an average duration of 6.2 ± 1.9 years. Rapid progressor was defined as MIC 1C through 1E while slow progressor was defined as 1A through 1B. Renal composite outcome (doubling of serum creatinine, 50% decline of estimated glomerular filtration rate [eGFR], or initiation of renal replacement therapy) as well as the annual percent change of height-adjusted total kidney volume (mHTKV-α), and eGFR decline (mGFR-α) were compared between groups.
RESULTS
A total of 110 patients (61.8%) were classified as rapid progressors. These patients were younger and showed a higher proportion of male patients. Rapid progressor was an independent predictor for renal outcome (hazard ratio, 4.09; 95% confidence interval, 1.23-13.54; p = 0.02). The mGFR-α was greater in rapid progressors (-3.58 mL/min per year in 1C, -3.7 in 1D, and -4.52 in 1E) compared with that in slow progressors (-1.54 in 1A and -2.06 in 1B). The mHTKV-α was faster in rapid progressors (5.3% per year in 1C, 9.4% in 1D, and 11.7% in 1E) compared with that in slow progressors (1.2% in 1A and 3.8% in 1B).
CONCLUSION
MIC is a good predictive tool to define rapid progressors in Korean ADPKD patients.
背景
梅奥影像分类（MIC）是预测常染色体显性多囊肾病（ADPKD）疾病进展的一种有用生物标志物。本研究旨在验证MIC在韩国ADPKD前瞻性队列中对肾脏结局的预测作用，并评估与疾病快速进展相关的临床参数。
方法
共纳入178例ADPKD患者，并对其进行前瞻性观察，平均观察时间为6.2±1.9年。快速进展者定义为MIC 1C至1E，而缓慢进展者定义为1A至1B。比较两组之间的肾脏复合结局（血清肌酐翻倍、估计肾小球滤过率[eGFR]下降50%或开始肾脏替代治疗）以及身高校正后的总肾体积年变化百分比（mHTKV-α）和eGFR下降率（mGFR-α）。
结果
共有110例患者（61.8%）被分类为快速进展者。这些患者更年轻，男性患者比例更高。快速进展者是肾脏结局的独立预测因素（风险比，4.09；95%置信区间，1.23 - 13.54；p = 0.02）。与缓慢进展者（1A组为-1.54，1B组为-2.06）相比，快速进展者的mGFR-α更大（1C组为-3.58 mL/分钟/年，1D组为-3.7，1E组为-4.52）。与缓慢进展者（1A组为1.2%，1B组为3.8%）相比，快速进展者的mHTKV-α更快（1C组为每年5.3%，1D组为9.4%，1E组为11.7%）。
结论
MIC是定义韩国ADPKD患者快速进展者的良好预测工具。
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