Clinical Manifestations of Autosomal Dominant Polycystic Kidney Disease in Patients Older Than 50 Years

Milutinovic, Jovan; Fialkow, Philip J.; Agodoa, Lawrence Y.; Phillips, Leon A.; Rudd, Thomas G.; Sutherland, Susan E.

doi:10.1016/s0272-6386(12)80768-2

Cited by 49 publications

(30 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At presentation, only one patient with the disease was asymptomatic and normotensive and denied any previous symptoms suggestive of the disease in our study. The main clinical manifestations of ADPKD in this cohort [12] were comparable to our study: hypertension (69%), a history of back and abdominal pain (47%), symptoms consistent with UTI (41%), hematuria (31%), but less frequency of end-stage renal failure (47%). Liver cysts were found in 44% of patients.…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Clinical Presentation and Outcomes of Autosomal Dominant Polycystic Kidney Disease in the Elderly

Helal¹,

Lassoued²,

Maı̈z³

et al. 2013

AJMSM

View full text Add to dashboard Cite

The patient characteristics and outcomes associated with autosomal dominant polycystic kidney disease (ADPKD) have not been characterized in elderly population. The purpose of theis study was to delineate clinical presentation and outcome of ADPKD in elderly patients. We performed a retrospective study. Thirty four elderly patients were diagnosed with ADPKD between 1975 and 2005. The diagnosis of ADPKD was made using family history and ultrasound. There were 21 (61.7%) males and 13 (38.3%) females. The mean age at the time of diagnosis of ADPKD was 69.74 ± 3.36 years (range, 65-79 years). The earliest clinical features were renal failure in 67.6%, back pain in 38.2%, and hypertension in 17.6%. Most common form of presentation was hypertension in 70.6%. Kidneys were palpable in 26.5%, and liver was palpable in 32.4%. Left ventricular hypertrophy confirmed by transthoracic echocardiography was found in 5(1.5%) patients. Three (0.8%) patients had colonic diverticula and two (0.6%) had neurological manifestation. Twenty six 26 patients (76.5%) patients had end stage renal disease and 30 patients (88.23 %) patients had anemia. Median follow-up period for all patients was 17.9 months (range, 1-120 months). Two (0.6%) patients developed renal carcinoma while five patients (14.7%) died within six years following diagnosis Anemia was the strongest and an independent predictor of poor renal outcome. (p<0.03). The diagnosis of ADPKD in elderly patients was made late in most cases, with patients already at end stage renal disease. Anemia is risk factor of poor renal prognosis. Eearly diagnosis and efforts at prevention of the disease progression and complications are most essential.

show abstract

Section: Discussionsupporting

confidence: 85%

“…And in one such study [12] the diagnosis of ADPKD was made in 56 % of at-risk subjects versus 17.6 % in our study. At presentation, only one patient with the disease was asymptomatic and normotensive and denied any previous symptoms suggestive of the disease in our study.…”

Section: Discussioncontrasting

confidence: 55%

Clinical Presentation and Outcomes of Autosomal Dominant Polycystic Kidney Disease in the Elderly

Helal¹,

Lassoued²,

Maı̈z³

et al. 2013

AJMSM

View full text Add to dashboard Cite

show abstract

“…[19] In our sample, no gender was overrepresented (47% men and 53% women, p=0.15) in accordance with previous epidemiological studies. Milutinovic and colleagues [28] also reported no difference between genders. In a sample of 140 United States patients selected from a database of families with polycystic kidneys, 64 (46%) were men and 76 (54%) were women in the same age range.…”

Section: Discussionmentioning

confidence: 93%

“…[22] Previous reports indicate up to 80% of hypertension in ADPKD subjects in other populations. [12,28] Renal lithiasis is also a frequent finding in ADPKD patients. [2] Our sample saw eight (11.9%) patients with ADPKD.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Clinical Profile of Patients with Polycystic Kidney Disease in Southern Brazil

et al. 2008

View full text Add to dashboard Cite

“…Once on dialysis nearly all affected individuals are hypertensive. [9][10][11][12][13] Hypertension used to be thought to be a significant factor in the progression of renal failure in ADPKD, 14 and it is the major risk factor for the premature cardiovascular disease that occurs, particularly in younger patients, and which in turn is the most frequent cause of mortality in ADPKD patients. 15 It is well recognised that deterioration of renal excretory function in ADPKD follows a unique time course in that glomerular filtration rate remains constant for many years and only declines relatively late in the course of the disease, when mechanical compression of normal renal tissue by cysts occurs.…”

Section: Introductionmentioning

confidence: 99%

Review: Autosomal Dominant Polycystic Kidney Disease: Role of the Renin-Angiotensin System in Raised Blood Pressure in Progression of Renal and Cardiovascular Disease

Lawson

Doulton

MacGregor

2006

J Renin Angiotensin Aldosterone Syst

View full text Add to dashboard Cite

Raised blood pressure (BP) is extremely common in individuals with autosomal dominant polycystic kidney disease (ADPKD) and is almost invariably raised once they develop renal failure. The underlying mechanisms for the rise in BP in individuals with ADPKD are unclear. The progressive number and enlargement of renal cysts, causing structural damage to the kidneys and, thereby, affecting tubular function as well as causing distortion of the glomeruli and renal ischaemia, is likely to be of primary importance.There is some evidence from animal models that there may be over-activity of the intra-renal renin-angiotensin system (RAS) that could account for the rise in BP. Studies in man have shown conflicting results, but a recent more carefully controlled study using both measurements of activity and pharmacological blockade of the RAS clearly demonstrated no evidence of over-activity of the circulating RAS in ADPKD compared to matched individuals with essential hypertension.A more likely explanation for the rise in BP that occurs in ADPKD is retention of sodium and water due to tubular damage. Disappointingly, in spite of good evidence that RAS blocking drugs slow the progression of other renal, particularly glomerular, diseases, there is little evidence to suggest this is true for patients with ADPKD. Nevertheless, there is no doubt that lowering BP in ADPKD is just as important, if not more important, as in essential hypertension to prevent cardiovascular disease and strokes, with a recommended BP target of < 120/80 mmHg.

show abstract

Clinical Manifestations of Autosomal Dominant Polycystic Kidney Disease in Patients Older Than 50 Years

Cited by 49 publications

References 10 publications

Clinical Presentation and Outcomes of Autosomal Dominant Polycystic Kidney Disease in the Elderly

Clinical Presentation and Outcomes of Autosomal Dominant Polycystic Kidney Disease in the Elderly

Frequency and Clinical Profile of Patients with Polycystic Kidney Disease in Southern Brazil

Review: Autosomal Dominant Polycystic Kidney Disease: Role of the Renin-Angiotensin System in Raised Blood Pressure in Progression of Renal and Cardiovascular Disease

Contact Info

Product

Resources

About