Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1

Ravine, David; Sheffield, L. J.; Danks, D. M.; Gibson, Robert N.; Walker, Rohen G; Kincaid-Smith, P

doi:10.1016/s0140-6736(94)92026-5

Cited by 511 publications

(309 citation statements)

References 23 publications

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“…Eligibility for the TEMPO 4 2 study required the following: men or women age Ͼ18 years fulfilling Ravine's diagnostic criteria (11), prior participation in a phase 1 tolvaptan ADPKD trial, and willingness to adhere to contraceptive precautions. Exclusion criteria included the following: inability to comply with study procedures, eGFR Ͻ30 ml/ min per 1.73 m 2 , anticipation of renal replacement therapy within 1 year, and active treatment that would affect end point measures (e.g., diuretic administration).…”

Section: Methodsmentioning

confidence: 99%

Tolvaptan in Autosomal Dominant Polycystic Kidney Disease

Higashihara

Torres

Chapman

et al. 2011

Clinical Journal of the American Society of Nephrology

141

110

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SummaryBackground and objectives Autosomal dominant polycystic kidney disease (ADPKD), a frequent cause of end-stage renal disease, has no cure. V2-specific vasopressin receptor antagonists delay disease progression in animal models.Design, setting, participants, and measurements This is a prospectively designed analysis of annual total kidney volume (TKV) and thrice annual estimated GFR (eGFR) measurements, from two 3-year studies of tolvaptan in 63 ADPKD subjects randomly matched 1:2 to historical controls by gender, hypertension, age, and baseline TKV or eGFR. Prespecified end points were group differences in log-TKV (primary) and eGFR (secondary) slopes for month 36 completers, using linear mixed model (LMM) analysis. Sensitivity analyses of primary and secondary end points included LMM using all subject data and mixed model repeated measures (MMRM) of change from baseline at each year. Pearson correlation tested the association between log-TKV and eGFR changes.Results Fifty-one subjects (81%) completed 3 years of tolvaptan therapy; all experienced adverse events (AEs), with AEs accounting for six of 12 withdrawals. Baseline TKV (controls 1422, tolvaptan 1635 ml) and eGFR (both 62 ml/min per 1.73 m 2 ) were similar. Control TKV increased 5.8% versus 1.7%/yr for tolvaptan (P Ͻ 0.001, estimated ratio of geometric mean 0.96 [95% confidence interval 0.95 to 0.97]). Corresponding annualized eGFR declined: Ϫ2.1 versus Ϫ0.71 ml/min per 1.73 m 2 /yr (P ϭ 0.01, LMM group difference 1.1 ml/min per 1.73 m 2 /yr [95% confidence interval 0.24 to 1.9]). Sensitivity analyses including withdrawn subjects were similar, whereas MMRM analyses were significant at each year for TKV and nonsignificant for eGFR. Increasing TKV correlated with decreasing eGFR (r ϭ Ϫ0.21, P Ͻ 0.01).Conclusion ADPKD cyst growth progresses more slowly with tolvaptan than in historical controls, but AEs are common.

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Section: Methodsmentioning

confidence: 99%

Tolvaptan in Autosomal Dominant Polycystic Kidney Disease

Higashihara

Torres

Chapman

et al. 2011

Clinical Journal of the American Society of Nephrology

141

110

View full text Add to dashboard Cite

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“…Abdominal and renal ultrasound were performed in the Radiology Department of the same institution in all cases by a single consultant radiologist using a Siemens Antares ultrasound system (Erlangen, Germany) and a 3-to 5-MHz convex-array transducer. The sonographic diagnosis of ADPKD was confirmed in 125 patients, based on criteria established by Ravine et al (6). All 125 patients who were recruited on the basis of the ultrasound findings were submitted to a clinical evaluation and to an unenhanced CT scan (Picker PQ 5000, Cleveland, OH), by which hepatic cysts could be also identified.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease Patients

Nishiura¹,

Neves²,

Eloi³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Nephrolithiasis (LIT) is more prevalent in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. Renal ultrasonography may underdetect renal stones because of difficulties imposed by parenchymal and/or cyst wall calcifications.Design, setting, participants, & measurements: A total of 125 patients with ADPKD underwent ultrasonography and unenhanced computed tomography (CT) scan, routine blood chemistry, and spot and 24-h urine collections.Results: CT scan detected calculi in 32 patients, including 20 whose previous ultrasonography revealed no calculi. The percentage of hypocitraturia was high but not statistically different between patients with ADPKD؉LIT or ADPKD. Hyperuricosuria and distal renal tubular acidosis were less prevalent but also did not differ between groups, whereas hyperoxaluria was significantly higher in the former. Hypercalciuria was not detected. Renal volume was significantly higher in patients with ADPKD؉LIT versus ADPKD, and a stepwise multivariate logistic regression analysis showed that a renal volume >500 ml was a significant predictor of LIT in patients with ADPKD and normal renal function, after adjustments for age and hypertension.Conclusions: CT scan was better than ultrasonography to detect LIT in patients with ADPKD. Larger kidneys from patients with ADPKD were more prone to develop stones, irrespective of the presence of metabolic disturbances.

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“…Measured GFR (mGFR) was measured as urinary iothalamate clearance (11) and total kidney volume (TKV) by magnetic resonance imaging. In addition, several markers indicating damage to the various parts of the nephron were measured in urine samples (12).…”

Section: Measurementsmentioning

confidence: 99%

Urinary EGF Receptor Ligand Excretion in Patients with Autosomal Dominant Polycystic Kidney Disease and Response to Tolvaptan

Harskamp¹,

Gansevoort²,

Boertien³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Recent animal experiments suggest that dysregulation of the EGF receptor pathway plays a role in the pathophysiology of autosomal dominant polycystic kidney disease (ADPKD). Research on EGF receptor ligands in humans with ADPKD is lacking. EGF receptor ligands were measured in patients with ADPKD at baseline and after treatment with a vasopressin V2 receptor antagonist (V2RA) because this information might provide a rationale for future V2RA combination therapy.Design, setting, participants, & measurements Blood and urine concentrations of the EGF receptor ligands heparin-binding (HB)-EGF, EGF, and TGF-a were measured by ELISAs in 27 patients with ADPKD who participated in a single-center study investigating a V2RA in 2011-2013 and in 27 controls who were selected from a general population-based observational study. Cyst fluid concentrations were also measured. In patients with ADPKD, ligands were measured at baseline, after 3-week treatment with a V2RA, and 3 weeks after drug withdrawal. The measured GFR (mGFR) was determined by iothalamate infusion, and total kidney volume was measured by magnetic resonance imaging.Results Urinary HB-EGF excretion and plasma concentration were higher in patients with ADPKD than in controls (median, . In contrast, urinary EGF excretion and plasma EGF concentration were lower in patients with ADPKD, whereas TGF-a did not differ between patients and controls. Higher HB-EGF excretion was correlated with more severe disease, assessed as lower mGFR (r=20.39; P=0.05), higher total kidney volume (r=0.39; P=0.05), and higher urinary excretion of albumin and heart-type fatty acid-binding protein, whereas higher EGF excretion and TGF-a excretion were negatively correlated with disease severity. During V2RA treatment, HB-EGF excretion increased (from 1.4 [1.2-1.9] to 2.4 [2.1-3.1] mg/24 hours; P,0.001).1 ConclusionIn patients with ADPKD, higher urinary HB-EGF excretion is correlated with more severe disease. Whether this association is causal needs to be investigated in intervention studies.

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Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1

Cited by 511 publications

References 23 publications

Tolvaptan in Autosomal Dominant Polycystic Kidney Disease

Tolvaptan in Autosomal Dominant Polycystic Kidney Disease

Evaluation of Nephrolithiasis in Autosomal Dominant Polycystic Kidney Disease Patients

Urinary EGF Receptor Ligand Excretion in Patients with Autosomal Dominant Polycystic Kidney Disease and Response to Tolvaptan

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