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Similar renal outcomes in children with ADPKD diagnosed by screening or presenting with symptoms

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Abstract

Autosomal dominant polycystic kidney disease (ADPKD) in children is sometimes considered to be a benign condition, with morbidity manifesting in adulthood. Therefore, diagnostic screening of children at risk is controversial. The aim of our study was to to compare the manifestations of ADPKD in children diagnosed by postnatal ultrasound (US) screening versus those presenting with symptoms. This was a retrospective chart review of children with ADPKD assessed in a single centre between 1987 and 2007. Age and reason for diagnosis were noted, and children were separated into two groups: (1) those diagnosed on the basis of family-based screening; (2) those presenting with a symptom. The two groups were compared for renal size, number of cysts, estimated glomerular filtration rate (eGFR), the presence of hypertension and microalbuminuria. In the 47 children with ADPKD (21 females) from 33 families who satisfied the enrollment criteria, mean (standard deviation) age at referral and last follow-up was 7.2 (4.4) and 12.9 (5.1) years, respectively, and the mean follow-up duration was 5.7 (3.6) years. Diagnosis was based on postnatal US screening in 31 children, whereas 16 were diagnosed after presenting with symptoms. The proportions of children with nephromegaly, hypertension, microalbuminuria and decreased eGFR, respectively, were similar in both groups. Based on these results, we conclude that renal-related morbidities, including hypertension and microalbuminia, do occur in children with ADPKD and at a similar frequency in those diagnosed after presenting with symptoms and those diagnosed upon postnatal screening. We suggest that at-risk children should have regular checks to detect hypertension. Moreover, affected children may benefit from novel therapies to minimise cystic disease progression.

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Acknowledgements

Our research is supported by Great Ormond Street Hospital Special Trustees. A.S.W’s research is supported by the Manchester Biomedical Research Centre and the University of Manchester.

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Authors and Affiliations

  1. Renal Unit, Great Ormond Street Hospital for Children NHS Trust, London, UK

    Djalila Mekahli & Detlef Bockenhauer

  2. Paediatric Nephrology Department, University Hospital Gasthuisberg, KULeuven, Herestraat 49, 3000, Leuven, Belgium

    Djalila Mekahli

  3. UCL Institute of Child Health, London, UK

    Adrian S. Woolf

  4. University of Manchester, Manchester, UK

    Adrian S. Woolf

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  1. Djalila Mekahli
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Correspondence to Djalila Mekahli.

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Mekahli, D., Woolf, A.S. & Bockenhauer, D. Similar renal outcomes in children with ADPKD diagnosed by screening or presenting with symptoms. Pediatr Nephrol 25, 2275–2282 (2010). https://doi.org/10.1007/s00467-010-1617-8

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