Update and review of adult polycystic kidney disease

Colbert, Gates B.; Elrggal, Mohamed E; Gaur, Lovy; Lerma, Edgar V.

doi:10.1016/j.disamonth.2019.100887

Cited by 39 publications

(55 citation statements)

References 92 publications

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“…In line with earlier studies, we found that the disease mostly presented in patients aged 31 years and above, with the highest occurrence within ages 31 to 40 years [1,11,12]. This is consistent with existent literature that ADPKD often occurs in adults over 30 years of age [2,13,14]. Similar to the studies of Arogundade et al, [15] and Chijioke et al, [16] we detected a male preponderance in disease incidents.…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, early detection and treatment of hypertension could hinder cyst development and cardiovascular complications [18]. Angiotensin converting enzyme inhibitors (ACEI)s and Angiotensin receptor blockers (ARBs) are the preferred medications used in the management of hypertension in ADPKD because they have been proven beneficial to: control cardiac dysfunction; decrease LVH and end organ damage; and reduce mortality [14]. Hence it is not surprising that most of our participants were on Lisinopril and Irbesartan.…”

Section: Discussionmentioning

confidence: 98%

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Demographic, diagnostic and therapeutic characteristics of autosomal dominant polycystic kidney disease in Ghana

et al. 2021

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Background Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the commonest of the hereditary kidney diseases and mostly ensues in utero with signs delayed until after several decades. This study assessed the demographic, diagnostic (clinical and biochemical features) and therapeutic patterns among ADPKD patients who attended the nephrology unit of Komfo Anokye Teaching Hospital (KATH) from 2007 to 2018. Methods This cross-sectional retrospective analysis of ADPKD patient records was conducted at the nephrology unit of KATH in October 2020. The records of 82 ADPKD was used for this study. Demographic, clinical, biochemical, ultrasonographic and therapeutic data was obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). Results ADPKD was most prevalent in people within the ages of 31–40 years (25.6 %), with a male (52.4 %) preponderance. The most common clinical features presented were flank pain (30.5 %) and bipedal swelling (18.3 %). Hypertension (42.7 %), urinary tract infections (UTIs) (19.5 %), and anemia (13.4 %) were the most common complications reported. Average level of HDL-c was higher in females (1.7) than in males (1.2) (p = 0.001). Hematuria (34 %) and proteinuria (66 %) were among the biochemical derangements presented. About 81.7 % had CKD at diagnosis with the majority in stages 1 (27.0 %), 3(23.2 %) and 5 (20.3 %). Poor corticomedullary differentiation was observed in 90.2 % of participants and increased echogenicity was observed in 89.0 % of the participants. Estimated GFR (eGFR) correlated positively with echotexture (r = 0.320, p = 0.005) and negatively with CMD (r= -0.303, p = 0.008). About 95.1 % of patients were on conservative therapy including: 73.2 %, 52.4 %, 22.0 %, 13.4 %, 8.5 % on Irebesartan/Lisinopril, Nifecard XL, Hydralazine, Methyldopa and Bisoprolol respectively for hypertension; 26.8 and 3.7 % on Gliclazide and Metformin respectively for Type 2 diabetes mellitus; 25.6 %, 24.4 and 18.3 % on CaCO3, fersolate and folic acid respectively as nutrient supplements with 4.9 % of participants on renal replacement therapy (RRT). Conclusions ADPKD occurs in people aged ≥ 31 years with a higher male preponderance. Clinical features include flank and abdominal pain, bipedal swelling, headache, amongst others. Uremia, hematuria, proteinuria, decreased eGFR, were the common biochemical derangements reported with higher severity detected in men. The therapeutic interventions mostly involved conservative therapy to manage symptoms and other comorbid conditions and rarely renal replacement therapy (RRT).

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Demographic, diagnostic and therapeutic characteristics of autosomal dominant polycystic kidney disease in Ghana

et al. 2021

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“…A median between ages of 30 -58 years have been documented previously for increased incidences of ESRD due to ADPKD thereby, making age a significant factor for onset of cardiovascular diseases including hypertension and CKD which may lead to PKD with subsequent progression to end-stage renal disease (ESRD) [12,16]. Several other studies have reported more critical illnesses in men than women, with earlier onset of hypertension, more severe hypertension, and earlier onset of ESRD and thus, ADPKD [17]. BMI and WHR were also significantly increased in the hypertensive subjects compared with control group.…”

Section: Discussionmentioning

confidence: 99%

Evidence of Risk Factors Associated with Autosomal Dominant Polycystic Kidney Disease in Newly Diagnosed Adult Hypertensive Patients in NAUTH Nnewi, Nigeria

Ukibe

Kalu

Emeje

et al. 2022

JPRI

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Aims & objectives: Due to other chronic diseases that are associated with hypertension and kidney disease, little or no attention has been paid to the existence of polycystic kidney disease in Nigeria. The present study aimed at assessing the prevalence of some risk factors of ADPKD among hypertensive adult patients in NAUTH, Nnewi, Anambra State, Nigeria Study design: A cross-sectional and prospective study Place and Duration of Study: The study was carried out at Medical out-patient, cardiology and nephrology units of NAUTH Nnewi between February and June, 2019. Methodology: A total of 160(80 newly diagnosed hypertensive and 80 normotensive subjects) aged between 25-75 years were randomly selected. Estimation of serum electrolytes, urea, creatinine, total calcium, eGFR and total protein, BMI and waist-hip ratio of the subjects were taken were done using standard laboratory methods. Results: 12.5% of the hypertensive subjects have undergone dialysis, 7.5% had kidney transplant, 13.8% had hematuria, 20% had proteinuria, 27.5% had recurrent kidney infection, 15% had kidney stone, 43.8% experienced abdominal/side pain, 20% have had abdominal hernias and 46.3% had elevated urea/creatinine. Mean values of age, BMI and WHR were significantly higher in hypertensive than control subjects (p =.05). Similarly, serum creatinine, urea, sodium and chloride were significantly higher with lower eGFR in hypertensive when compared with control group (p =.05). eGFR in female was significantly lower compared with male hypertensive (p = .05). The mean SBP and DBP were significantly higher in hypertensive compared with control group (p = .05). Conclusion: 30% of the hypertensive subjects had multiple signs and symptoms of ADPKD, suggesting evidence of high prevalence of ADPKD in the hypertensive patients. Routine screening of family members with hypertension and symptomatic cases of hypertension using ultrasound imaging is strongly recommended for confirmation of presence PKD.

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“…Pierre Rayer first identified polycystic kidney disease in 1841 and Felix Lejars formally coined the term "polycystic kidney disease" in 1888 (Colbert et al 2020 ). ADPKD is the most prevalent of all hereditary forms of CKD in the United States of America (USA), reaching 600,000–700,000.…”

Section: Epidemiologymentioning

confidence: 99%

Autosomal dominant polycystic kidney disease and pioglitazone for its therapy: a comprehensive review with an emphasis on the molecular pathogenesis and pharmacological aspects

Saini¹,

Saini²,

Singh

2020

Mol Med

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Autosomal dominant polycystic kidney disease (ADPKD) is an inherited chronic kidney disorder (CKD) that is characterized by the development of numerous fluid-filled cysts in kidneys. It is caused either due to the mutations in the PKD1 or PKD2 gene that encodes polycystin-1 and polycystin-2, respectively. This condition progresses into end-stage renal disorder if the renal or extra-renal clinical manifestations remain untreated. Several clinical trials with a variety of drugs have failed, and the only Food and Drugs Administration (FDA) approved drug to treat ADPKD to date is tolvaptan that works by antagonizing the vasopressin-2 receptor (V2R). The pathology of ADPKD is complex and involves the malfunction of different signaling pathways like cAMP, Hedgehog, and MAPK/ERK pathway owing to the mutated product that is polycystin-1 or 2. A measured yet substantial number of preclinical studies have found pioglitazone to decrease the cystic burden and improve the renal function in ADPKD. The peroxisome proliferator-activated receptor-gamma is found on the epithelial cells of renal collecting tubule and when it gets agonized by pioglitazone, confers efficacy in ADPKD treatment through multiple mechanisms. There is only one clinical trial (ongoing) wherein it is being assessed for its benefits and risk in patients with ADPKD, and is expected to get approval from the regulatory body owing to its promising therapeutic effects. This article would encompass the updated information on the epidemiology, pathophysiology of ADPKD, different mechanisms of action of pioglitazone in the treatment of ADPKD with preclinical and clinical shreds of evidence, and related safety updates.

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Update and review of adult polycystic kidney disease

Cited by 39 publications

References 92 publications

Demographic, diagnostic and therapeutic characteristics of autosomal dominant polycystic kidney disease in Ghana

Demographic, diagnostic and therapeutic characteristics of autosomal dominant polycystic kidney disease in Ghana

Evidence of Risk Factors Associated with Autosomal Dominant Polycystic Kidney Disease in Newly Diagnosed Adult Hypertensive Patients in NAUTH Nnewi, Nigeria

Autosomal dominant polycystic kidney disease and pioglitazone for its therapy: a comprehensive review with an emphasis on the molecular pathogenesis and pharmacological aspects

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