Tato Wasako, Suwabe Tatsuya, Ubara Yoshifumi, Oba Yuki, Mizuno Hiroki, Ikuma Daisuke, Yamanouchi Masayuki, Inoue Noriko, Sekine Akinari, Tanaka Kiho, Hasegawa Eiko, Wada Takehiko, Sawa Naoki
Department of Nephrology, Toranomon Hospital Kajigaya, Kawasaki, Japan.
Department of Nephrology, Nara Medical University, Kashihara, Japan.
PLoS One. 2025 Jul 21;20(7):e0328133. doi: 10.1371/journal.pone.0328133. eCollection 2025.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease and Polycystic liver disease (PLD) is the most common extrarenal manifestation of ADPKD. Various non-inherited factors have been reported to affect total kidney volume (TKV) in ADPKD. However, the non-inherited factors affecting liver volume (LV) in ADPKD are unknown.
We aimed to identify the factors affecting LV and TKV in ADPKD; and to analyze the relationship between changes in these parameters and arterial stiffness, assessed using brachial-ankle pulse wave velocity (baPWV).
We enrolled 165 patients (66 men and 99 women; mean age 47.3 ± 6.9 years). Univariable analysis revealed that sex, mean baPWV, ΔbaPWV, tolvaptan use, hyperlipidemia, hyperuricemia, Hb concentration, eGFR, proteinuria, and height-adjusted TKV (htTKV) were significantly associated with height-adjusted LV (htLV) at baseline. Multivariate analysis showed that sex, BMI, ΔbaPWV, and tolvaptan use were significantly associated with htLV at baseline. The baseline htLV correlated with ΔbaPWV (r = 0.32, p < 0.0001). Univariable linear mixed model analysis revealed that sex, mean baPWV, ΔbaPWV, tolvaptan use, hyperuricemia, Hb concentration, eGFR, and proteinuria significantly affected the change in htLV. Multivariate linear mixed model analysis revealed that sex, BMI, and tolvaptan use significantly affected the change in htLV. The change in the htLV ratio was larger in patients with a higher ΔbaPWV (p < 0.0001). Whereas, ΔbaPWV was not a significant factor for the baseline htTKV and the changes in htTKV in univariable and multivariable analysis.
We have shown that ΔbaPWV is a predictor of baseline htLV, and the chronological changes in htLV in patients with ADPKD.
常染色体显性遗传性多囊肾病（ADPKD）是最常见的遗传性肾病，多囊肝病（PLD）是ADPKD最常见的肾外表现。已有报道称多种非遗传因素会影响ADPKD患者的总肾体积（TKV）。然而，影响ADPKD患者肝脏体积（LV）的非遗传因素尚不清楚。
我们旨在确定影响ADPKD患者LV和TKV的因素；并分析这些参数变化与使用肱踝脉搏波速度（baPWV）评估的动脉僵硬度之间的关系。
我们纳入了165例患者（66例男性和99例女性；平均年龄47.3±6.9岁）。单变量分析显示，性别、平均baPWV、ΔbaPWV、托伐普坦使用情况、高脂血症、高尿酸血症、血红蛋白浓度、估算肾小球滤过率（eGFR）、蛋白尿以及身高校正后的TKV（htTKV）在基线时与身高校正后的LV（htLV）显著相关。多变量分析表明，性别、体重指数（BMI）、ΔbaPWV和托伐普坦使用情况在基线时与htLV显著相关。基线htLV与ΔbaPWV相关（r = 0.32，p < 0.0001）。单变量线性混合模型分析显示，性别、平均baPWV、ΔbaPWV、托伐普坦使用情况、高尿酸血症、血红蛋白浓度、eGFR和蛋白尿显著影响htLV的变化。多变量线性混合模型分析显示，性别、BMI和托伐普坦使用情况显著影响htLV的变化。ΔbaPWV较高的患者htLV比值变化更大（p < 0.0001）。而在单变量和多变量分析中，ΔbaPWV不是基线htTKV及htTKV变化的显著因素。
我们已经表明，ΔbaPWV是ADPKD患者基线htLV以及htLV随时间变化的一个预测指标。
