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Martínez V, Furlano M, Sans L, Pulido L, García R, Pérez-Gómez MV, Sánchez-Rodríguez J, Blasco M, Castro-Alonso C, Fernández-Fresnedo G, Robles NR, Valenzuela MP, Naranjo J, Martín N, Pilco M, Agraz-Pamplona I, González-Rodríguez JD, Panizo N, Fraga G, Fernández L, López MT, Dall'Anese C, Ortiz A, Torra R. Autosomal dominant polycystic kidney disease in young adults. Clin Kidney J 2023; 16:985-995. [PMID: 37260991 PMCID: PMC10229292 DOI: 10.1093/ckj/sfac251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND The clinical manifestations of autosomal dominant polycystic kidney disease (ADPKD) usually appear in adulthood, however pediatric series report a high morbidity. The objective of the study was to analyze the clinical characteristics of ADPKD in young adults. METHODS Family history, hypertension, albuminuria, estimated glomerular filtration rate (eGFR) and imaging tests were examined in 346 young adults (18-30 years old) out of 2521 patients in the Spanish ADPKD registry (REPQRAD). A literature review searched for reports on hypertension in series with more than 50 young (age <30 years) ADPKD patients. RESULTS The mean age of this young adult cohort was 25.24 (SD 3.72) years. The mean age at diagnosis of hypertension was 21.15 (SD 4.62) years, while in the overall REPQRAD population was aged 37.6 years. The prevalence of hypertension was 28.03% and increased with age (18-24 years, 16.8%; 25-30 years, 36.8%). Although prevalence was lower in women than in men, the age at onset of hypertension (21 years) was similar in both sexes. Mean eGFR was 108 (SD 21) mL/min/1.73 m2, 38.0% had liver cysts and 3.45% of those studied had intracranial aneurysms. In multivariate analyses, hematuria episodes and kidney length were independent predictors of hypertension (area under the curve 0.75). The prevalence of hypertension in 22 pediatric cohorts was 20%-40%, but no literature reports on hypertension in young ADPKD adults were found. CONCLUSIONS Young adults present non-negligible ADPKD-related morbidity. This supports the need for a thorough assessment of young adults at risk of ADPKD that allows early diagnosis and treatment of hypertension.
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Affiliation(s)
- Víctor Martínez
- Nephrology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Mónica Furlano
- Inherited Kidney Diseases, Nephrology Department, Fundació Puigvert, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU)
| | - Laia Sans
- Nephrology Department, Hospital del Mar, Barcelona, Spain
| | - Lissett Pulido
- Nephrology Department, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Rebeca García
- Nephrology Department, Hospital La Mancha-Centro, Alcázar de San Juan, Spain
| | - María Vanessa Pérez-Gómez
- Nephrology Department, IIS-Fundación Jiménez Diaz, Universidad Autónoma de Madrid, IRSIN, RICORS40, Madrid, Spain
| | - Jinny Sánchez-Rodríguez
- Nephrology Department, IIS-Fundación Jiménez Diaz, Universidad Autónoma de Madrid, IRSIN, RICORS40, Madrid, Spain
| | - Miquel Blasco
- Nephrology and Kidney Transplantation Department, Hospital Clínic, Institute of Biomedical Research August Pi i Sunyer (IDIPABS), University of Barcelona, Barcelona, Spain
| | | | | | | | | | - Javier Naranjo
- Nephrology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Nadia Martín
- Nephrology Department, Hospital Universitari de Girona Dr Josep Trueta, Gerona, Spain
| | - Melissa Pilco
- Nephrology Department, Hospital Universitari de Girona Dr Josep Trueta, Gerona, Spain
| | | | | | - Nayara Panizo
- Nephrology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Gloria Fraga
- Pediatric Nephrology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Loreto Fernández
- Nephrology Department, Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | | | | | - Alberto Ortiz
- Nephrology Department, IIS-Fundación Jiménez Diaz, Universidad Autónoma de Madrid, IRSIN, RICORS40, Madrid, Spain
| | - Roser Torra
- Inherited Kidney Diseases, Nephrology Department, Fundació Puigvert, Institut d’Investigació Biomèdica Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona, Barcelona, Spain
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Yildiz A, Sag S, Gul CB, Güllülü S, Can FE, Bedir Ö, Aydin MF, Oruç A, Demirel S, Akgür S, Güllülü M, Ersoy A. Morning blood pressure surge in early autosomal dominant polycystic kidney disease and its relation with left ventricular hypertrophy. Ren Fail 2021; 43:223-230. [PMID: 33478355 PMCID: PMC7833015 DOI: 10.1080/0886022x.2020.1864403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The activation of the sympathetic nervous system, which usually leads to a swift surge in blood pressure in the morning hours (MBPS) may be the cause of left ventricular hypertrophy (LVH) and endothelial dysfunction (ED) in early autosomal dominant polycystic kidney disease (ADPKD) patients. We studied the association between MBPS and LVH in ADPKD patients with preserved renal functions. METHODS Patients with ADPKD with preserved renal functions were enrolled. Prewaking MBPS was calculated using ambulatory blood pressure monitoring. The patients were categorized as MBPS (≥median) and non-MBPS ( RESULTS Fifty-six patients (30 females and 26 males) were enrolled. Gender distribution was similar-among-the-groups. The mean age was higher in the MBPS group (50.1 ± 13 vs 37.3 ± 10.3). Urinary albumin (49.5 vs 16 mg/g creatinine, p < 0.001), hs-CRP (0.59 vs 0.37 mg/dl, p = 0.045) LVMI (124 ± 27.7 vs 95.2 ± 19.7 g/m2, p < 0.001) and mean awake SBP surge was higher (42 vs 20 mmHg, p < 0.001) and FMD (%) was lower (14.4 ± 6.6 vs 18.9 ± 5.7, p = 0.009) in MBPS group. In the binary logistic regression analysis, the presence of MBPS in model 1 (OR: 6.625, 95% CI [1.048-41.882] p = 0.044), and age in model 2 (OR: 1.160, 95% CI [1.065-1.263] p = 0.001) were the only independent determinant of LVH. CONCLUSIONS MBPS seems to be an important and independent determinant of LVH in ADPKD patients with preserved renal functions. It may be worth assessing the effect of reduction in MBPS as a new therapeutic target to prevent LVH in-patients-with-ADPKD.
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Affiliation(s)
- Abdülmecit Yildiz
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Saim Sag
- Department of Cardiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Cuma Bulent Gul
- Department of Nephrology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Sümeyye Güllülü
- Department of Cardiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Fatma Ezgi Can
- Department of Biostatistics, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Ömer Bedir
- Department of Cardiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | | | - Ayşegül Oruç
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sadettin Demirel
- Department of Physiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Suat Akgür
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mustafa Güllülü
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Alparslan Ersoy
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
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Natale P, Perrone RD, Tong A, Harris T, Hannan E, Ju A, Burnette E, Casteleijn NF, Chapman A, Eastty S, Gansevoort RT, Hogan M, Horie S, Knebelmann B, Lee R, Mustafa RA, Sandford R, Baumgart A, Craig JC, Rangan GK, Sautenet B, Viecelli AK, Amir N, Evangelidis N, Guha C, Logeman C, Manera K, Matus Gonzalez A, Howell M, Strippoli GFM, Cho Y. Establishing a core outcome measure for pain in patients with autosomal dominant polycystic kidney disease: a consensus workshop report. Clin Kidney J 2021; 15:407-416. [PMID: 35211300 PMCID: PMC8862067 DOI: 10.1093/ckj/sfab110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 11/21/2022] Open
Abstract
Background Pain is the highest prioritized patient-reported outcome in people with autosomal dominant polycystic kidney disease (ADPKD) but remains infrequently and inconsistently measured in clinical trials and poorly managed in clinical settings. A recently completed systematic review of pain in ADPKD identified 26 different outcome measures. None of these measures were considered appropriate as a core outcome measure due to the lack of patient-important dimensions, inadequate content, relatively long duration of completion time and limited evidence to support psychometric robustness. Methods We convened an international Standardized Outcomes in Nephrology–Polycystic Kidney Disease consensus workshop involving 21 patients/caregivers and 40 health professionals (clinicians, nurses, researchers, policy makers and industry representatives) from 18 countries to discuss the identification or development of a core outcome measure for pain. Results Four themes were identified highlighting fundamental issues for the measurement of pain in ADPKD: distressing and disrupting life participation; variability and ambiguity in defining pain; stigma, frustration and adaptation to pain; and ensuring validity and feasibility of pain measures. Conclusions Existing measures were found to be insufficient in capturing pain as a core outcome and there was consensus on the need for a new validated measure that is simple, succinct and addresses the impact of pain on life participation. This measure will facilitate the appropriate prioritization of pain in all trials and guide clinical decision making in people with ADPKD.
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Affiliation(s)
- Patrizia Natale
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Ronald D Perrone
- Medicine, Nephrology, Clinical and Translational Research Center, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Tess Harris
- Polycystic Kidney Disease International, London, UK
| | - Elyssa Hannan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Angela Ju
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | | | - Niek F Casteleijn
- Department of Urology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Arlene Chapman
- Department of Nephrology, University of Chicago, Chicago, IL, USA
| | | | - Ron T Gansevoort
- Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Marie Hogan
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, NY, USA
| | - Shigeo Horie
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Advanced Informatics for Genetic Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Bertrand Knebelmann
- Service de Nephrologie, Université de Paris, APHP, Hôpital Universitaire Necker, Paris, France
| | | | - Reem A Mustafa
- Department of Internal Medicine, Division of Nephrology and Hypertension, University of Kansas Medical Centre, Kansas City, KS, USA
| | - Richard Sandford
- Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - Amanda Baumgart
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Gopala K Rangan
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Bénédicte Sautenet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Hôpital de Tours, Tours, France
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
| | - Andrea K Viecelli
- Australasian Kidney Trials Network, University of Queensland, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Noa Amir
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Evangelidis
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Charlotte Logeman
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Karine Manera
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Andrea Matus Gonzalez
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Giovanni F M Strippoli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Yeoungjee Cho
- Australasian Kidney Trials Network, University of Queensland, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
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