Quality of Life in Autosomal Dominant Polycystic Kidney Disease Patients not yet on Dialysis

SummaryBackground and objectives Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency.Design, setting, participants, & measurements This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal function. Magnetic resonance imaging and iothalamate clearance were used to measure htTKV and GFR, respectively. The association between baseline htTKV and the attainment of stage 3 CKD (GFR ,60 ml/min per 1.73 m 2 ) during follow-up was determined.Results After a mean follow-up of 7.9 years, stage 3 CKD was attained in 30.7% of the enrollees. Using baseline htTKV, negative correlations with GFR increased from 20.22 at baseline to 20.65 at year 8. In multivariable analysis, a baseline htTKV increase of 100 cc/m significantly predicted the development of CKD within 8 years with an odds ratio of 1.48 (95% confidence interval: 1.29, 1.70). In receiver operator characteristic curve analysis, baseline htTKV of 600 cc/m most accurately defined the risk of developing stage 3 CKD within 8 years with an area under the curve of 0.84 (95% confidence interval: 0.79, 0.90). htTKV was a better predictor than baseline age, serum creatinine, BUN, urinary albumin, or monocyte chemotactic protein-1 excretion (P,0.05).Conclusions Baseline htTKV $600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.

show abstract

“…TKV associates with the development of ESRD and significantly affects patients' quality of life (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Kidney Volume and Functional Outcomes in Autosomal Dominant Polycystic Kidney Disease

Chapman

Bost

Torres

et al. 2012

Clinical Journal of the American Society of Nephrology

Self Cite

329

299

View full text Add to dashboard Cite

show abstract

“…Pain has been reported as a very frequent symptom of ADPKD patients, affecting up to 60% of them 15,32 and jeopardizing their quality of life. 33 Because that symptom involves a series of sensorial qualities and subjective aspects, 22,32 it requires a careful investigation by a multiprofessional team. Duarte et al 23 have emphasized the importance of using proper instruments to assess the situations and experiences in the health area, so that reliable information is obtained.…”

Section: Results Translation and Transcultural Adaptation Of The Quesmentioning

confidence: 99%

Tradução, adaptação cultural e aplicação de um questionário de dor para pacientes com doença renal policística

Eloi¹,

Nishiura²,

Heilberg³

2010

J. Bras. Nefrol.

View full text Add to dashboard Cite

“…A number of studies have investigated symptom burden in ADPKD patients [5,7,8,9]. The largest of these studies did not find an association between kidney volume and pain, except for a small subgroup with very large kidneys [5].…”

Section: Introductionmentioning

confidence: 99%

“…The largest of these studies did not find an association between kidney volume and pain, except for a small subgroup with very large kidneys [5]. Another study concluded that quality of life was not different between patients with a total kidney volume (TKV) larger or smaller than 1,000 mL, but the effect of liver volume was not assessed [8]. Two studies that analyzed the effect of liver volume on quality of life, showed conflicting results, with one study finding no relation and the other a significant, but weak association between liver volume and symptom burden [10,11].…”

Section: Introductionmentioning

confidence: 99%

The Association of Combined Total Kidney and Liver Volume with Pain and Gastrointestinal Symptoms in Patients with Later Stage Autosomal Dominant Polycystic Kidney Disease

D’Agnolo¹,

Casteleijn²,

Gevers³

et al. 2017

Am J Nephrol

View full text Add to dashboard Cite

Background: There is an ongoing debate if and how kidney and liver volume are associated with pain and gastrointestinal (GI) symptoms in autosomal dominant polycystic kidney disease (ADPKD) patients. Since both kidney and liver volume could interact, we investigated whether combined total kidney and liver volume had stronger associations with ADPKD-related pain and GI symptoms than the volumes of the organs separately. Methods: We used baseline data from the DIPAK-1 study, which included ADPKD patients with an estimated glomerular filtration rate (eGFR) between 30 and 60 mL/min/1.73 m². MR imaging was performed to measure height-adjusted total kidney volume (hTKV), height-adjusted total liver volume (hTLV) and the combination of both (height-adjusted total kidney liver volume [hTKLV]). Results: Three hundred nine ADPKD patients were included with a mean age of 48 ± 7 years, 53% female, eGFR 50 ± 11 mL/min/1.73 m² and median hTKV, hTLV and hTKLV of 1,095 (758-1,669), 1,173 (994-1,523) and 2,496 (1,972-3,352) mL/m, respectively. ADPKD-related pain and GI symptoms were present in, respectively, 27.5 and 61.2% of patients. Gender was no effect modifier in the association between kidney and/or liver volume, and symptom burden, indicating that all models could be tested in the overall study population. hTKLV and hTLV were significantly associated with pain and GI symptoms, whereas hTKV was not. Model testing revealed that the associations of pain and GI symptoms with hTKLV were significantly stronger than with hTKV (p = 0.04 and p = 0.04, respectively) but not when compared to hTLV (p = 0.2 and p = 0.5, respectively). Conclusions: This study indicates that combined kidney and liver volume was associated with the presence and severity of pain and GI symptoms in ADPKD, with a more prominent role for hTLV than for hTKV.

show abstract

Quality of Life in Autosomal Dominant Polycystic Kidney Disease Patients not yet on Dialysis

Abstract: Conclusions: Predialysis ADPKD patients assess their quality of life similar to the general population. Age, BMI, pulse pressure, pain medication intake, and education level link to their physical well-being.

Cited by 70 publications

References 24 publications

Kidney Volume and Functional Outcomes in Autosomal Dominant Polycystic Kidney Disease

Kidney Volume and Functional Outcomes in Autosomal Dominant Polycystic Kidney Disease

Tradução, adaptação cultural e aplicação de um questionário de dor para pacientes com doença renal policística

The Association of Combined Total Kidney and Liver Volume with Pain and Gastrointestinal Symptoms in Patients with Later Stage Autosomal Dominant Polycystic Kidney Disease

Contact Info

Product

Resources

About