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Multiple urinary tract infections are associated with genotype and phenotype in adult polycystic kidney disease

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Abstract

Background

Urinary tract infections (UTI) are one of the important clinical presentations in patients with autosomal dominant polycystic kidney disease (ADPKD). The association between UTI among genotypic and phonotypic properties of ADPKD patients is still obscure. Thus, we investigated the relationship between UTI and polycystin gene mutation with total kidney volume.

Methods

Forty patients with ADPKD patients with a history of more than two UTI and age–gender-matched 40 ADPKD patients without UTI history enrolled in the study. Ambulatory blood pressure monitoring was performed in all participants. Magnetic resonance imaging (MRI) was performed with a 1.5-T system, and total kidney volumes were calculated using mid-slice technique. To determine PKD1 and PKD2 genotype, we performed molecular and genetic tests involving the following steps: DNA isolation, next-generation sequencing (NGS) and data analysis.

Results

ADPKD patients with UTI had lower eGFR values than those without UTI [64.9 (32.2–100.8) vs 89.5 (59.0–110.0) (p = 0.041)]. In addition, patients with UTI had significantly increased height-adjusted total kidney volume than patients without UTI [950 (290–1350) vs 345 (243–780.0) (p = 0.005)]. Multiple logistic regression analysis showed that the PKD1-truncating mutation and hTKV independently predicted UTI. The sensitivity and specificity of hTKV were 65% and 77% (cutoff > 727 cm3) with an area of under the ROC curve of 0.70 (95% CI 0.56–0.85, p = 005).

Conclusions

ADPKD patients with larger kidneys and PKD1 mutation are susceptible to increased risk of multiple UTI. Additionally, renal function decreased in ADPKD patients with multiple UTI history.

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Acknowledgements

We thank all study participants who enrolled in the study.

Funding

There is no funding of the study.

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey

    Eray Eroglu, Ismail Kocyigit, Murat Hayri Sipahioglu, Bulent Tokgoz & Oktay Oymak

  2. Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey

    Mustafa Cetin

  3. Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey

    Gokmen Zararsiz

  4. Department of Radiology, Erciyes University Medical Faculty, Kayseri, Turkey

    Hakan Imamoglu

  5. Department of Genetics, Erciyes University Medical Faculty, Kayseri, Turkey

    Ruslan Bayramov

  6. Department of Infectious Disease, Erciyes University Medical Faculty, Kayseri, Turkey

    Sinem Tastan

Authors
  1. Eray Eroglu
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  2. Ismail Kocyigit
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  3. Mustafa Cetin
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  7. Sinem Tastan
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  8. Murat Hayri Sipahioglu
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  9. Bulent Tokgoz
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  10. Oktay Oymak
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Contributions

EE and IK conceived the study and designed the protocol which was implemented by MC, ST and EE. These authors also recruited the participants. BT, MHS, OO and GZ helped with the study design. RB performed the tests for determining PKD mutation. HI reported the measurements of the patients’ total kidney volumes. IK, EE and MC coordinated the study. ST and MC collected the data of the study. EE and IK wrote the paper. All authors participated in data analysis and interpretation, and also read and approved the final manuscript.

Corresponding author

Correspondence to Eray Eroglu.

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All authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Eroglu, E., Kocyigit, I., Cetin, M. et al. Multiple urinary tract infections are associated with genotype and phenotype in adult polycystic kidney disease. Clin Exp Nephrol 23, 1188–1195 (2019). https://doi.org/10.1007/s10157-019-01752-3

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  • DOI: https://doi.org/10.1007/s10157-019-01752-3

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