Total Kidney Volume, Hypertension, and Deterioration of Kidney Function in Children with Early-Stage ADPKD.

Several studies have shown that total kidney volume (TKV) measurements may serve as a non-invasive imaging biomarker for monitoring and predicting the progression of autosomal dominant polycystic kidney disease (ADPKD) in children. : This study aimed to evaluate the relationship between height-adjusted TKV (htTKV), estimated glomerular filtration rate (GFR), and blood pressure, assessed using 24 h ambulatory blood pressure monitoring (ABPM), in children with early-stage ADPKD. The study was conducted with 72 children, mean age 12.46 ± 3.76 (5.42-17.92). Hypertension (HT) was diagnosed in (20) 28% of children. ABPM allowed the identification of previously undiagnosed HT in 12 (16.7%) children. Decreased GFR was demonstrated in 10 (14%) children, and hyperfiltration in 5 (7%) children. Significantly higher htTKV and calculated TKV z-score and more frequent decreases in GFR were observed in hypertensive children ( = 0.018; 0.020 and 0.010, respectively). The study demonstrated a significant inverse correlation between htTKV and GFR (r -0.25; = 0.032). The TKV z-score showed a very good correlation with all ABPM parameters, except for DBP and DBP z-score during the day. Receiver operating curve (ROC) analysis showed that htTKV and TKV z-score had good diagnostic value for predicting a decline in GFR (AUC 0.808, < 0.001), but were not useful for predicting the onset of HT (AUC 0.697, = 0.010). There is a relationship between TKV, GFR, and blood pressure parameters in children with early-stage ADPKD. The TKV z-score can be useful for predicting GFR decline. Children with ADPKD and increasing TKV require careful blood pressure monitoring.