Early progresión markers in autosomal dominant polycystic kidney disease (ADPKD). A longitudinal study in patients with normal GFR

AZURMENDI PABLO; FRAGA ADRIANA R; VALDEZ MARTA; ARRIZURIETA ELVIRA; MARTÍN RODOLFO

- Philadelphia

Congreso; Annual Meeting of American Society of Nephrology (ASN)- Kidney Week 2011 - Philadelphia, PA; 2011

American Society of Nephrology (ASN)

It is well known that total renal volume (TRV) is the best phenotypic parameter to evaluate ADPKD progression. However, parameters others than TRV are currently a matter of debate in early stages of the disease when glomerular filtration rate (GFR) is preserved. We have previously reported that urinary monocyte chemoattractant protein-1 (MCP-1) and albuminuria (UACR) could be early markers of progression. The UACR > 6.8 mg /gCr (hUACR) is associated with high levels of urine MCP-1 and risk of subclinical atherosclerosis compared with UACR ≤ 6.8 (nUACR). To investigate whether there is an interaction between TRV, GFR and MCP-1, and if UACR could predict the course of the disease, we present a longitudinal (30 ± 1 months) study of 32 young patients (26 ± 1 years old). The TRV (measured by ultrasound), GFR (by MDRD) and urine MCP-1 (ELISA) baseline values were 415 ± 52.8 ml, 108 ± 3 ml/min/1.73m2 and 152 ± 32 ng/gCr, respectively. An association among TRV, GFR and urine MCP-1 annual change was found, regardless of their baseline values , UACR, age, sex, and antihypertensive treatment. The annual changes in TRV and urine MCP-1 were higher in hUACR (131 ± 33 ml and 108 ± 49%) than nUACR (48 ± 41 ml and - 5 ± 16 %) respectively (p < 0.05). GFR change was not different according to UACR, remained stable in patients treated with angiotensin converting enzyme I inhibitors vs untreated normotensive subjects (3 ± 5 and -5 ± 2 ml/min/year, p